Individual
PRINCY JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6420 CLAYTON RD, RICHMOND HEIGHTS, MO 63117-1811
(314) 768-8722
Mailing address
6420 CLAYTON RD, RICHMOND HEIGHTS, MO 63117-1811
(314) 768-8722
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
RN-84496
NM
Other
Enumeration date
12/03/2019
Last updated
12/03/2019
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