Individual
MRS. LISA JEZIORSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
229 VALLEYOAK CT, BALLWIN, MO 63021-6550
(636) 222-1474
Mailing address
229 VALLEYOAK CT, BALLWIN, MO 63021-6550
(636) 222-1474
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2008031584
MO
Other
Enumeration date
09/28/2011
Last updated
08/11/2022
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