Individual
MRS. KELLY LYNN WITTENAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. SLP
Contact information
Practice address
17770 MUELLER RD., WILDWOOD, MO 63038
(314) 749-4744
Mailing address
401 BALLWIN ESTATES CT., BALLWIN, MO 63021
(314) 749-4744
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2009012464
MO
Other
Enumeration date
02/25/2010
Last updated
01/30/2017
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