Individual
HEATHER LILLEDAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP, M.ED.
Contact information
Practice address
2800 OLD MUEGGE ROAD, SAINT CHARLES, MO 63303
(636) 443-4055
Mailing address
2800 OLD MUEGGE RD, SAINT CHARLES, MO 63303-3033
(636) 443-4055
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2000174934
MO
Other
Enumeration date
11/01/2016
Last updated
11/02/2016
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