Provider Demographics
NPI:1649087974
Name:ALLMEROTH, ANDREW JOSEPH (BS SLP)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JOSEPH
Last Name:ALLMEROTH
Suffix:
Gender:M
Credentials:BS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5804 PEBBLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:WARDSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65101-8325
Mailing Address - Country:US
Mailing Address - Phone:573-292-6694
Mailing Address - Fax:
Practice Address - Street 1:403 E 10TH ST
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MO
Practice Address - Zip Code:65251-2009
Practice Address - Country:US
Practice Address - Phone:573-590-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20240387052355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant