Amelia Louise Glass, M.S, CF-SLP

Individual provider Active NPI Speech-Language Pathologist · Lake Saint Louis, MO

NPI 1265728018 · NPPES record last updated Jun 21, 2011

Key facts

NPI
1265728018
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2010038790 (MO)
Practice address
2 Harbor Bend CT
Suite 102
Lake Saint Louis, MO 63367-1478
Phone
(636) 695-2095
Fax
(636) 695-2080
NPI assigned
Jun 21, 2011
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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2010038790MOMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2010038790 MO Yes

Addresses

Primary practice location

2 Harbor Bend CT
Suite 102
Lake Saint Louis, MO 63367-1478

Mailing address

2 Harbor Bend CT
Suite 102
Lake Saint Louis, MO 63367-1478
Phone (636) 695-2095

Other providers in Lake Saint Louis, MO

All providers in Lake Saint Louis, MO · Speech-Language Pathologist in Missouri

Sources for this page

Verify at the official NPI Registry.