Individual
JAIMIE ANN LOUISE KOENIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
801 N 11TH ST, MEDICAID DEPARTMENT, SAINT LOUIS, MO 63101-1015
(314) 231-3720
Mailing address
801 N 11TH ST, MEDICAID DEPARTMENT, SAINT LOUIS, MO 63101-1015
(314) 231-3720
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2008018152
MO
Other
Enumeration date
12/28/2008
Last updated
08/23/2010
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