Individual
MRS. STACY NICOLE KILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, MA, CCCSLP, PLPC
Contact information
Practice address
1715 DEER TRACKS TRL STE 260, SAINT LOUIS, MO 63131-1855
(314) 616-9609
Mailing address
35 JACKS CABIN DR, DEFIANCE, MO 63341-1329
(314) 616-9609
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
MO
101YM0800X
Mental Health Counselor
—
—
235Z00000X
Speech-Language Pathologist
SZ4252
FL
235Z00000X
Speech-Language Pathologist
—
MO
Other
Enumeration date
07/30/2007
Last updated
05/12/2021
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