Individual
MRS. JESSICA PANGBORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
2011 CORONA RD STE 301, COLUMBIA, MO 65203-2548
(314) 543-3860
Mailing address
15444 S GREENWOOD ST, OLATHE, KS 66062-3460
(414) 405-4403
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2011013608
MO
Other
Enumeration date
06/06/2012
Last updated
06/06/2012
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