Individual
ANDREA GAST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
605 CALAMAR CT, O FALLON, MO 63368-7088
(314) 265-6440
Mailing address
605 CALAMAR CT, O FALLON, MO 63368-7088
(314) 265-6440
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
114060
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09145765
ASHA
MO
01
—
114060
STATE OF MISSOURI 114060
MO
Enumeration date
05/11/2009
Last updated
05/11/2009
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