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Organization
LET'S TALK TEEN CLINIC INC.
Active
Organization
LET'S TALK TEEN CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STAISY YOUNG WHNP-BC (NURSE PRACTITIONER)
(314) 494-2584
Entity
Organization
Contact information
Practice address
119 CHURCH STREET, SUITE 131, FERGUSON, MO 63135
(314) 494-2584
Mailing address
119 CHURCH STREET, SUITE 131, FERGUSON, MO 63135
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
2002031370
MO
Other
Enumeration date
06/10/2013
Last updated
10/29/2013
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