Individual
MISS TARA NICOLE GLORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
400 13TH ST, FENTON, MO 63026-5562
(636) 343-7662
Mailing address
400 13TH ST, FENTON, MO 63026-5562
(636) 343-7662
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2014207826
MO
Other
Enumeration date
05/17/2018
Last updated
05/17/2018
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