Individual
MISS KELLY MARIE BERESWILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
214 HARTMAN PL, SAINT CLAIR, MO 63077-2464
(636) 629-9826
Mailing address
2553 CHRISTOPHER OAKS CT, SAINT LOUIS, MO 63129-5544
(314) 749-0969
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2008030937
MO
Other
Enumeration date
10/16/2008
Last updated
10/16/2008
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