Doctor Name: | REETA RENAE WINFREY |
NPI Number: | 1154377083 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 108890 |
Business Practice Address: | 1 Jefferson Barracks Dr Saint Louis, MO - 631254181 |
Business Phone Number: | 3148946675 |
Business Fax Number: | 3148946615 |
Mailing Address: | 2158 Wilderness Trl, BARNHART |
State: | MO |
Postal Code: | 630121266 |
Phone Number: | 6364648411 |
Fax Number: | |
NPI Enumeration Date: | 05/25/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 108890 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |