Provider Demographics
NPI:1003212416
Name:NEUKIRCH, MAUREEN ELAINE (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:ELAINE
Last Name:NEUKIRCH
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1170 TIMBER RUN DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-4482
Mailing Address - Country:US
Mailing Address - Phone:314-469-0606
Mailing Address - Fax:314-469-3294
Practice Address - Street 1:1170 TIMBER RUN DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-4482
Practice Address - Country:US
Practice Address - Phone:314-469-0606
Practice Address - Fax:314-469-3294
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-12
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO108343235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist