Individual
MRS. SHIRLEY W ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDLD
Contact information
Practice address
1015 BOWLES AVE, FENTON, MO 63026-2394
(636) 496-5815
Mailing address
410 WILCOX AVE, KIRKWOOD, MO 63122
(636) 496-2543
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
20040226599
MO
Other
Enumeration date
03/29/2012
Last updated
03/29/2012
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