Individual
MICHELLE RENAE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
951 WEST COLLEGE ST, LINCOLN COUNTY REORGANIZED, TROY, MO 63379-1112
(636) 528-7652
(636) 528-2411
Mailing address
PO BOX 420, TROY, MO 63379-0420
(636) 528-7652
(636) 528-2411
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2004016672
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
465102812
—
MO
Enumeration date
02/28/2007
Last updated
02/19/2009
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