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Individual

IRENE SANSOUCIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
4333 BUTLER HILL RD, SAINT LOUIS, MO 63128-3717
(314) 894-2484
(314) 894-2591
Mailing address
123 HARBOR CT, FENTON, MO 63026-7516
(314) 398-1198

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2011026615
MO

Other

Enumeration date
07/13/2018
Last updated
07/13/2018
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