Provider Demographics
NPI:1871845404
Name:MURRAY, COLLEEN ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:ELIZABETH
Last Name:MURRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:COLLEEN
Other - Middle Name:ELIZABETH
Other - Last Name:MARTENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2926 STRATFORD DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-6039
Mailing Address - Country:US
Mailing Address - Phone:636-578-4410
Mailing Address - Fax:
Practice Address - Street 1:2926 STRATFORD DR
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-6039
Practice Address - Country:US
Practice Address - Phone:636-578-4410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-05
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012015942235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist