Individual
CARLA TELLOR GRUNDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
121 PARK RD, SAINT LOUIS, MO 63119-2528
(314) 452-4415
Mailing address
121 PARK RD, SAINT LOUIS, MO 63119-2528
(314) 452-4415
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
146004652
IL
235Z00000X
Speech-Language Pathologist
2008022570
MO
235Z00000X
Speech-Language Pathologist
22008391A
IN
235Z00000X
Speech-Language Pathologist
Primary
30005117
NC
235Z00000X
Speech-Language Pathologist
30892
CA
235Z00000X
Speech-Language Pathologist
SA21055
FL
235Z00000X
Speech-Language Pathologist
SP4430
ME
Other
Enumeration date
02/21/2013
Last updated
05/29/2026
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