Individual
MRS. KELLY KAY FAGALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, MA, MT-BC
Contact information
Practice address
453 SUMMIT PLACE CT, FENTON, MO 63026-3573
(314) 258-0913
Mailing address
453 SUMMIT PLACE CT, FENTON, MO 63026-3573
(636) 305-1614
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
—
—
Other
Enumeration date
01/02/2007
Last updated
07/08/2007
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