Individual
RACHEL ELIZABETH O'BANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP CBIS
Contact information
Practice address
12380 DE PAUL DR, BRIDGETON, MO 63044-2511
(314) 447-9741
Mailing address
1570 MAPLEWOOD CT, EDWARDSVILLE, IL 62025-3186
(618) 792-4568
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2018016956
MO
Other
Enumeration date
04/12/2020
Last updated
04/12/2020
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