Individual
PHYNE KIERRA ANN PETTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3309 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63139-1101
(314) 206-3700
Mailing address
3309 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63139-1101
(314) 206-3700
(314) 206-3708
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/26/2025
Last updated
08/26/2025
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