Individual
AMANDA ROUILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
607 S 3RD ST, ODESSA, MO 64076-1417
(816) 633-5334
Mailing address
607 S 3RD ST, ODESSA, MO 64076-1417
(816) 633-5334
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2015039954
MO
Other
Enumeration date
11/14/2016
Last updated
11/14/2016
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