Tara Gretchen Mouser MCDCCCSLP

NPI 1003019761 - Speech-Language Pathologist - 235Z00000X

NPI Details
NPI 1003019761
Gender Female
Enumeration Date 06/08/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
505 COURT ST.
BLOOMFIELD MO, 63825, US
Phone (573) 568-4562
Fax (573) 568-4563
Business Location
1321 BUISNESS HWY 60 W
DEXTER MO, 63841, US
Phone (573) 624-3150
Fax
Toxanomy
Taxonomy Code 235Z00000X
License State Missouri
License Number 112138
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According to our database, Mrs. Tara Gretchen Mouser MCDCCCSLP NPI is 1003019761, taxonomy code is 235Z00000X and license number is 112138, license state is located at Missouri. Tara Gretchen Mouser MCDCCCSLP physically located at 505 Court St., Bloomfield MO, 63825. NPI Number Tara Gretchen Mouser MCDCCCSLP has the Individual type.

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1003019761 NPI number is provided on an as is basis without warranty of any kind. 1003019761 is maintained by the National Plan & Provider Enumeration System. The contents of Tara Gretchen Mouser MCDCCCSLP are for informational purposes only.