Doctor Name: | MRS. MARY MARGARET VAN DE RIET |
NPI Number: | 1225174337 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA CCC SLP |
License Number: | 01928 |
Business Practice Address: | 2843 Community Ln High Ridge, MO - 630492337 |
Business Phone Number: | 6366713360 |
Business Fax Number: | 6366717269 |
Mailing Address: | 2843 Community Ln, HIGH RIDGE |
State: | MO |
Postal Code: | 630492337 |
Phone Number: | 6366713360 |
Fax Number: | 6366717269 |
NPI Enumeration Date: | 01/29/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 01928 |
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 |