Individual
TAJANETTE RAQUEL SCONYERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
12747 OLIVE BLVD STE 300, SAINT LOUIS, MO 63141-6269
(314) 648-4279
Mailing address
12747 OLIVE BLVD STE 300, SAINT LOUIS, MO 63141-6269
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2017014334
MO
Other
Enumeration date
11/25/2020
Last updated
03/22/2021
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