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Individual

LOU BONASTIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
15834 CLAYTON RD, ELLISVILLE, MO 63011-2212
(636) 227-2339
Mailing address
16617 WYCLIFFE PLACE DR, WILDWOOD, MO 63005-6635

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2001010959
MO

Other

Enumeration date
02/05/2007
Last updated
07/08/2007
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