Individual
BAILEY CHAKLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12380 DE PAUL DR, BRIDGETON, MO 63044-2511
(314) 447-9710
Mailing address
1210 OXFORD HILL CT APT 6, SAINT LOUIS, MO 63146-5718
(618) 578-8619
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2022031592
MO
Other
Enumeration date
03/17/2023
Last updated
03/17/2023
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