Provider Demographics
NPI:1871989590
Name:MONTES-KOLENCE, CELIA GRACE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CELIA
Middle Name:GRACE
Last Name:MONTES-KOLENCE
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Gender:F
Credentials:MS, CCC-SLP
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Mailing Address - Street 1:2440 EXECUTIVE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-5607
Mailing Address - Country:US
Mailing Address - Phone:314-348-7327
Mailing Address - Fax:314-754-9926
Practice Address - Street 1:2440 EXECUTIVE DR STE 200
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-5607
Practice Address - Country:US
Practice Address - Phone:314-348-7327
Practice Address - Fax:314-754-9926
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-09
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA2202011700235Z00000X
IL146.009976235Z00000X
CO0005656235Z00000X
MO2009021161235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOM53210784658Medicaid
MO034716OtherUNITED HEALTHCARE