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Individual

CASEY COULTIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSCCC-SLP

Contact information

Practice address
1200 W COLLEGE ST, LIBERTY, MO 64068-1036
(816) 781-3020
Mailing address
524 NW 87TH TERRACE, KANSAS CIY, MO 64155

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2009012779
MO

Other

Enumeration date
03/28/2012
Last updated
03/28/2012
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