Individual
MRS. AMANDA S LEROUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1015 N GRAND AVE, DONIPHAN, MO 63935-1779
(573) 996-4239
(573) 996-9086
Mailing address
1015 N GRAND AVE, DONIPHAN, MO 63935-1779
(573) 996-4239
(573) 996-9086
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2007006282
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007006282
SP/LANG PATH.LICENSE
MO
Enumeration date
08/09/2007
Last updated
12/03/2013
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