Individual
MS. MADELINE ELAINE BRUNGARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
4500 FOREST PARK AVE, DEPT OTOLARYNGOLOGY, 5TH FL, SAINT LOUIS, MO 63108-2114
(314) 362-7509
(888) 452-4025
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-7509
(888) 452-4025
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2025044991
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
460166075
—
MO
Enumeration date
06/01/2018
Last updated
12/08/2025
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