Individual
MS. DANIELLE BOURBINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA,CCC-SLP
Contact information
Practice address
610 S ENGINEER AVE, SEDALIA, MO 65301-4734
(660) 826-5926
Mailing address
610 S ENGINEER AVE, SEDALIA, MO 65301-4734
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2017010395
MO
Other
Enumeration date
08/24/2017
Last updated
10/30/2018
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