Individual
JILLIAN ALYSSA O'CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
276 AUTUMN RDG, ALTENBURG, MO 63732-9181
(573) 450-7632
Mailing address
276 AUTUMN RDG, ALTENBURG, MO 63732-9181
(573) 450-7632
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2014016034
MO
Other
Enumeration date
10/29/2014
Last updated
10/04/2024
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