Individual
ALISHA FOSSETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12110 CLAYTON RD, SAINT LOUIS, MO 63131-2516
(314) 989-8100
Mailing address
5578 MARDEL AVE, SAINT LOUIS, MO 63109-1507
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
129791
MO
Other
Enumeration date
04/26/2018
Last updated
04/26/2018
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