Christy Taryn Brewer

Individual provider Active NPI Speech-Language Pathologist · De Soto, MO

NPI 1174080642 · NPPES record last updated Feb 21, 2019

Key facts

NPI
1174080642
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
3260 Baisch Dr
De Soto, MO 63020-5046
Phone
(636) 586-2291
NPI assigned
Feb 21, 2019
Sex
Female
Sole proprietor
Yes

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aspen Valley Senior Homes, LLC Current
since Apr 17, 2022
Accepting new patients

Specialties & licenses

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

Addresses

Primary practice location

3260 Baisch Dr
De Soto, MO 63020-5046

Mailing address

16566 Branchwood Dr
Wildwood, MO 63011-1845
Phone (636) 346-9634

Other providers in De Soto, MO

All providers in De Soto, MO · Speech-Language Pathologist in Missouri

Sources for this page

Verify at the official NPI Registry.