Provider Demographics
NPI:1497364293
Name:VUONG, JASMINE RENEE
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:RENEE
Last Name:VUONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JASMINE
Other - Middle Name:RENEE
Other - Last Name:EWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:66 WALNUT POINT CT
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-4541
Mailing Address - Country:US
Mailing Address - Phone:314-482-1275
Mailing Address - Fax:
Practice Address - Street 1:66 WALNUT POINT CT
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63304-4541
Practice Address - Country:US
Practice Address - Phone:314-482-1275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-28
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty