NPIMap

Stephanie Jerden, M.S. SLP-CCC

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

NPI 1508930645 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1508930645
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2004021786 (MO)
Practice address
11097 Saint Charles Rock Rd
Saint Ann, MO 63074-1509
Phone
(314) 213-8100
Fax
(314) 213-8610
NPI assigned
Nov 20, 2006
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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2004021786MOMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pattonville School District Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2004021786 MO Yes

Addresses

Primary practice location

11097 Saint Charles Rock Rd
Saint Ann, MO 63074-1509

Mailing address

11097 Saint Charles Rock Rd
Saint Ann, MO 63074-1509
Phone (314) 213-8100

Other providers in Saint Ann, MO

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

Sources for this page

Verify at the official NPI Registry.