Jennifer Revell Valid NPI
Individual provider · Speech-Language Pathologist · O Fallon, MO
- NPI
- 1518636257
- Type
- Individual (Type 1)
- Primary specialty
- Speech-Language Pathologist
- Specialty group
- Speech, Language and Hearing Service Providers
- Taxonomy code
- 235Z00000X
- License number
- 2021034984 (MO)
- Sex
- Female
- Sole proprietor
- Yes
- Enumerated
- 2021-09-07
- Last updated
- 2021-09-07
Practice location
3450 Pheasant Meadow Dr
O Fallon, MO 63368-7324
(636) 379-0173