Mariette Adcock Lovinger

Individual provider Active NPI Speech-Language Pathologist · Kingdom City, MO

NPI 1558746503 · NPPES record last updated Feb 17, 2016

Key facts

NPI
1558746503
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2015023935 (MO)
Practice address
4171 County Road 240
Kingdom City, MO 65262-1111
Phone
(573) 642-4333
NPI assigned
Jul 20, 2015
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

LicenseStateTypeSpecialty
2015023935MOMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2015023935 MO Yes

Addresses

Primary practice location

4171 County Road 240
Kingdom City, MO 65262-1111

Mailing address

2801 W Broadway
Unit S4
Columbia, MO 65203-1271
Phone (314) 504-9694

Other providers in Kingdom City, MO

All providers in Kingdom City, MO · Speech-Language Pathologist in Missouri

Sources for this page

Verify at the official NPI Registry.