Individual
MRS. KATELYN DANIELLE FORTHAUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
3488 JEFFCO BLVD, ARNOLD, MO 63010-6015
(636) 464-5439
(636) 464-5438
Mailing address
5323 KINGS PARK DR, SAINT LOUIS, MO 63129-3137
(636) 208-4570
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
2019027196
MO
235Z00000X
Speech-Language Pathologist
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019027196
MISSOURI BOARD CERTIFIED LICENSE-SPEECH LANGUAGE PATHOLOGY
MO
Enumeration date
08/21/2019
Last updated
12/11/2024
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