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Individual

TESSA DUNIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
801 BRIM ST, DESLOGE, MO 63601-3441
(573) 431-0223
Mailing address
3171 HIGHWAY H, FARMINGTON, MO 63640-7049
(573) 915-3185

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2018034573
MO

Other

Enumeration date
06/18/2019
Last updated
06/18/2019
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