Individual
TERESA KATHLEEN VIVOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
206 W SPRUCE ST, HOUSTON, MO 65483-1126
(417) 967-3024
Mailing address
4112 S HWY E, NORWOOD, MO 65717-9369
(417) 349-2667
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
2022037040
MO
Other
Enumeration date
09/15/2025
Last updated
09/15/2025
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