| Doctor Name: | MR. ROBERT VAN GIESEN |
| NPI Number: | 1841629839 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 2013016908 |
| Business Practice Address: | 5323 Ville Maria Ln Hazelwood, MO - 630421143 |
| Business Phone Number: | 3149537650 |
| Business Fax Number: | 3149537663 |
| Mailing Address: | 15955 New Halls Ferry Rd, FLORISSANT |
| State: | MO |
| Postal Code: | 630311227 |
| Phone Number: | 3149535000 |
| Fax Number: | |
| NPI Enumeration Date: | 11/11/2013 |
| NPI Last Update Date: | 11/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2013016908 |
| 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 |