Valerie M Gray

Individual provider Active NPI Speech-Language Pathologist · Maryville, MO

NPI 1063769461 · NPPES record last updated Aug 6, 2012

Key facts

NPI
1063769461
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2009023886 (MO)
Practice address
1429 S Munn Ave
Maryville, MO 64468-2756
Phone
(660) 582-3768
Fax
(660) 582-2807
NPI assigned
Aug 6, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2009023886MOMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Maryville R-II Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2009023886 MO Yes

Addresses

Primary practice location

1429 S Munn Ave
Maryville, MO 64468-2756

Mailing address

1429 S Munn Ave
Maryville, MO 64468-2756
Phone (660) 582-3768

Other providers in Maryville, MO

All providers in Maryville, MO · Speech-Language Pathologist in Missouri

Sources for this page

Verify at the official NPI Registry.