Individual
STACY PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
739 JEFFCO BLVD, ARNOLD, MO 63010-1432
(636) 296-3396
Mailing address
1672 IVY CHASE LN, FENTON, MO 63026-2685
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
107079
MO
Other
Enumeration date
05/16/2018
Last updated
05/16/2018
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