Individual
MRS. EMILY F GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
906 SOUT ST, STOCKTON R-I SCHOOL DISTRICT, STOCKTON, MO 65785-0190
(417) 276-6161
(417) 276-3765
Mailing address
PO BOX 190, 906 SOUTH ST, STOCKTON, MO 65785-0190
(417) 276-6161
(417) 276-3765
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2004002564
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
466036100
—
MO
Enumeration date
02/23/2007
Last updated
02/19/2009
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