| Doctor Name: | MS. KRISTIN D BAGBY |
| NPI Number: | 1730465329 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS |
| License Number: | 2011032194 |
| Business Practice Address: | 2120 Bryan Valley Commercial Dr O Fallon, MO - 633663495 |
| Business Phone Number: | 3147741859 |
| Business Fax Number: | 6362408096 |
| Mailing Address: | 2120 Bryan Valley Commercial Dr., OFALLON |
| State: | MO |
| Postal Code: | 63366 |
| Phone Number: | 3147741859 |
| Fax Number: | 6362408096 |
| NPI Enumeration Date: | 10/26/2011 |
| NPI Last Update Date: | 10/26/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2011032194 |
| 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 |