Individual
MRS. MAKENZIE PETERMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
825 PEARL AVE, JOPLIN, MO 64801-9025
(417) 625-5200
Mailing address
825 PEARL AVE, JOPLIN, MO 64801-9025
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2019031361
MO
Other
Enumeration date
07/24/2019
Last updated
11/01/2021
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