Healthcare Provider Details

I. General information

NPI: 1487295879
Provider Name (Legal Business Name): SARA JANE KRONE SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2019
Last Update Date: 10/05/2020
Certification Date: 10/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4810 MEADOWS PKWY
WELDON SPRING MO
63304-2227
US

IV. Provider business mailing address

4545 CENTRAL SCHOOL RD
SAINT CHARLES MO
63304-7113
US

V. Phone/Fax

Practice location:
  • Phone: 636-851-6000
  • Fax:
Mailing address:
  • Phone: 636-851-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2019006627
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: