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General NPI Number Information
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NPI Number | 1801005434
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Entity Type | Organization
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Legal Business Name | EDUCATIONAL TUTORING
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 625 N EUCLID AVE SUITE 445
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City | SAINT LOUIS
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State | MO
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Zip | 63108-1660
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Country | US
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Telephone | 314-361-3388
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Fax |
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Provider Business Mailing Address
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Address Line | 3837 VAILE AVE SUITE E
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City | FLORISSANT
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State | MO
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Zip | 63034-2210
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Country | US
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Telephone | 314-921-8886
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TEMISHA YVETTE BAKER
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Credential |
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Telephone | 314-921-8886
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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 |
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License Number State |
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