Individual
MS. THERESA M O'DONOGHUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
5825 ITASKA ST, SAINT LOUIS, MO 63109-3117
(314) 807-9865
Mailing address
5825 ITASKA ST, SAINT LOUIS, MO 63109-3117
(314) 807-9865
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2010026880
MO
Other
Enumeration date
03/23/2011
Last updated
03/23/2011
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