Provider Demographics
NPI:1790958239
Name:STRAWN, CHARLOTTE R (MHS,CCC-A)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:R
Last Name:STRAWN
Suffix:
Gender:F
Credentials:MHS,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 N KEENE ST
Mailing Address - Street 2:SUITE 401
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-7193
Mailing Address - Country:US
Mailing Address - Phone:573-874-6984
Mailing Address - Fax:573-874-8737
Practice Address - Street 1:303 N KEENE ST
Practice Address - Street 2:SUITE 401
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6623
Practice Address - Country:US
Practice Address - Phone:573-874-6984
Practice Address - Fax:573-874-8737
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01686231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO224684221Medicare PIN