Judith A Thurmond
Individual provider Active NPI Speech-Language Pathologist · Fredericktown, MO
NPI 1154459477 · NPPES record last updated Feb 19, 2009
Key facts
- NPI
- 1154459477
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 104802 (MO)
- Practice address
- Fredericktown R-1 School Dist
803 East Highway 72
Fredericktown, MO 63645-7292 - Phone
- (573) 783-2570
- Fax
- (573) 783-7045
- NPI assigned
- Feb 28, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104802 | MO | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 104802 | MO | Yes |
Addresses
Primary practice location
Fredericktown R-1 School Dist
803 East Highway 72
Fredericktown, MO 63645-7292
Mailing address
803 East Highway 72
Fredericktown, MO 63645-7292
Phone (573) 783-2570
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 467463105 | Medicaid | MO |
Other providers in Fredericktown, MO
- Derek Wayne Stricklin
- Brandi Nichole Tabor
- John Tedder
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- Carol Marie Thurman
- Hannah Rachelle Tinnin
- Town & Country Grocers of Fredericktown MD Inc
- Town & Country Grocers of Fredericktown Mo Inc
- Tradewinds Palliative Care LLC.
- Dorcas Unruh
All providers in Fredericktown, MO · Speech-Language Pathologist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.