Individual
PITU HALDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
3108 W TRUMAN BLVD, JEFFERSON CITY, MO 65109-4918
(573) 893-3063
(573) 893-1944
Mailing address
121 PALISADES DR, JEFFERSON CITY, MO 65109-6182
(573) 893-4274
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2004027776
MO
Other
Enumeration date
10/24/2013
Last updated
10/24/2013
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