| Doctor Name: | ANNA MANDA |
| NPI Number: | 1164862603 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 146.011784 |
| Business Practice Address: | 16216 Baxter Rd Suite 330 Chesterfield, MO - 630174770 |
| Business Phone Number: | 6367333330 |
| Business Fax Number: | |
| Mailing Address: | 16216 Baxter Rd, Suite 330 CHESTERFIELD |
| State: | MO |
| Postal Code: | 630174770 |
| Phone Number: | 6367333330 |
| Fax Number: | |
| NPI Enumeration Date: | 06/28/2013 |
| NPI Last Update Date: | 09/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 146.011784 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| 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 |