Doctor Name: | MEGHANN KONCZAL |
NPI Number: | 1225411184 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 2015023187 |
Business Practice Address: | 2120 Bryan Valley Commercial Dr O Fallon, MO - 633663495 |
Business Phone Number: | 6362408096 |
Business Fax Number: | |
Mailing Address: | 1722 Canary Cv, SAINT LOUIS |
State: | MO |
Postal Code: | 631441605 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/09/2015 |
NPI Last Update Date: | 07/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2015023187 |
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 |