Doctor Name: | MICHELLE RENAE KING |
NPI Number: | 1477681864 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCC SLP |
License Number: | 2004016672 |
Business Practice Address: | 951 West College St Lincoln County Reorganized Troy, MO - 633791112 |
Business Phone Number: | 6365287652 |
Business Fax Number: | 6365282411 |
Mailing Address: | Po Box 420, TROY |
State: | MO |
Postal Code: | 633790420 |
Phone Number: | 6365287652 |
Fax Number: | 6365282411 |
NPI Enumeration Date: | 02/28/2007 |
NPI Last Update Date: | 02/19/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2004016672 |
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 |