Individual
ALEXANDRA VIDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
950 FRANCIS PL STE 115, CLAYTON, MO 63105-2465
(314) 644-1978
Mailing address
5390 PERSHING AVE APT 207, SAINT LOUIS, MO 63112-1799
(919) 995-9592
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2021027330
MO
Other
Enumeration date
09/08/2021
Last updated
09/08/2021
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