Individual
BRANDY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7349 VERMONT AVE, SAINT LOUIS, MO 63111-3034
(131) 488-5976
Mailing address
7349 VERMONT AVE, SAINT LOUIS, MO 63111-3034
(131) 488-5976
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/07/2022
Last updated
03/07/2022
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