Individual
MRS. BETH MARIE EWING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
801 N 11TH ST, MEDICAID DEPARTMENT, SAINT LOUIS, MO 63101-1015
(314) 260-9406
Mailing address
4418 TENNESSEE AVE, SAINT LOUIS, MO 63111-1048
(314) 260-9406
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2006013769
MO
Other
Enumeration date
08/28/2007
Last updated
08/28/2007
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