Individual
SUE ROESLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5301 FARAON ST, SUITE 160, SAINT JOSEPH, MO 64506-3373
(816) 671-4840
(816) 671-4845
Mailing address
5301 FARAON ST, SUITE 160, SAINT JOSEPH, MO 64506-3373
(816) 671-4840
(816) 671-4845
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
00951
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00951
MO AUDIOLOGY LICENSE
MO
Enumeration date
10/26/2006
Last updated
07/08/2007
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