Provider Demographics
NPI:1639332323
Name:GERAGHTY SELTZER, PEGGY A (MS CCC SLP)
Entity Type:Individual
Prefix:MS
First Name:PEGGY
Middle Name:A
Last Name:GERAGHTY SELTZER
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:MS
Other - First Name:MARGARET
Other - Middle Name:G
Other - Last Name:SELTZER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCC SLP
Mailing Address - Street 1:1349 LIGGETT DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126-1341
Mailing Address - Country:US
Mailing Address - Phone:314-550-6421
Mailing Address - Fax:
Practice Address - Street 1:1349 LIGGETT DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126-1341
Practice Address - Country:US
Practice Address - Phone:314-550-6421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO256240235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist