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General NPI Number Information
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NPI Number | 1154456473
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Entity Type | Organization
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Legal Business Name | METROPOLITAN SPEECH AND LANGUAGE CENTER
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8390 DELMAR BLVD SUITE 202
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City | SAINT LOUIS
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State | MO
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Zip | 63124-2117
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Country | US
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Telephone | 314-225-9769
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Fax | 314-432-7503
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Provider Business Mailing Address
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Address Line | 8390 DELMAR BLVD SUITE 202
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City | SAINT LOUIS
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State | MO
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Zip | 63124-2117
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Country | US
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Telephone | 314-225-9769
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Fax | 314-432-7503
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL OSCAR CARLBERG
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Credential | M.S.
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Telephone | 314-225-9769
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 01385
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License Number State | MO
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