| NPI | 1518162791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH A FULLER Speech Pathologist 314-892-8862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO LifeState) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2008-06-16 |