Individual
KODI KEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10797 COUNTY ROAD 5100, ROLLA, MO 65401-8077
(573) 528-2711
Mailing address
10797 COUNTY ROAD 5100, ROLLA, MO 65401-8077
(573) 528-2711
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2020026821
MO
Other
Enumeration date
08/24/2020
Last updated
06/05/2025
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