Tina Lynn Ebert CCC-SLP

NPI 1215169743 - Speech-Language Pathologist - 235Z00000X

NPI Details
NPI 1215169743
Gender Female
Enumeration Date 08/17/2009
Last Updated 08/17/2009
Entity Type Individual
Active Over 7 years ago
Practice Location
110 VIRGIL ST
O FALLON MO, 63366-2637, US
Phone (636) 272-6620
Fax
Business Location
1128 GIBRALTAR POINT DR
SAINT CHARLES MO, 63304-5037, US
Phone (314) 882-5530
Fax
Toxanomy
Taxonomy Code 235Z00000X
License State Missouri
License Number 2009009829
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According to our database, Mrs. Tina Lynn Ebert CCC-SLP NPI is 1215169743, taxonomy code is 235Z00000X and license number is 2009009829, license state is located at Missouri. Tina Lynn Ebert CCC-SLP physically located at 110 Virgil St, O Fallon MO, 63366-2637. NPI Number Tina Lynn Ebert CCC-SLP has the Individual type.

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1215169743 NPI number is provided on an as is basis without warranty of any kind. 1215169743 is maintained by the National Plan & Provider Enumeration System. The contents of Tina Lynn Ebert CCC-SLP are for informational purposes only.