Individual
SUSAN ELIZABETH LICHTENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
860 W. VEST ST., MARSHALL, MO 65340
(660) 886-7414
Mailing address
860 W. VEST ST., MARSHALL, MO 65340
(660) 886-7414
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2016032495
MO
Other
Enumeration date
02/06/2018
Last updated
09/04/2019
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