Corey Charles Bolen, MA CCC-SLP Valid NPI

Individual provider · Speech-Language Pathologist · O Fallon, MO

NPI

1851519581

Type

Individual (Type 1)

Primary specialty

Speech-Language Pathologist

Specialty group

Speech, Language and Hearing Service Providers

Taxonomy code

235Z00000X

License number

2005002432 (MO)

Sex

Male

Sole proprietor

No

Enumerated

2007-04-20

Last updated

2023-08-28