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1003690207
LILY BLACK
SAINT LOUIS, MO
NPI
1003690207
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist
(Licence: MO 2023034137)
Enumeration Date
2023-08-21
Last Update Date
2023-08-21
Business Address
LILY BLACK
10911 TESSON FERRY RD
SAINT LOUIS, MO 63123-6114
Phone number: 314-729-2485
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Mailing Address
LILY BLACK
401 MEDINA DR
SAINT LOUIS, MO 63122-1427
Phone number: 314-825-2232
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