Individual
MIKAYLA DANIELLE ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1371 YMCA DR, FESTUS, MO 63028-2617
(636) 465-0726
(636) 465-0747
Mailing address
1371 YMCA DR, FESTUS, MO 63028-2617
(636) 465-0726
(636) 465-0747
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2021034058
MO
Other
Enumeration date
08/24/2021
Last updated
10/08/2024
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