MEDICARE: MRS. COLLEEN ELIZABETH MURRAY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	2012015942	MO

General Provider Information

NPI Number	:	1871845404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. COLLEEN ELIZABETH MURRAY

Provider Business Mailing Address
First Line	:	2926 STRATFORD DR
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63303-6039
Country	:	US
Telephone Number	:	636-578-4410
Fax Number	:

Provider Business Practice Location Address
First Line	:	2926 STRATFORD DR
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63303-6039
Country	:	US
Telephone Number	:	636-578-4410
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2012
Last Update Date	:	07/25/2022

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