Individual
KENEISHIA ELIJAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16720 STONE CREEK CT, FLORISSANT, MO 63034-1019
(314) 736-4275
(314) 260-6781
Mailing address
16720 STONE CREEK CT, FLORISSANT, MO 63034-1019
(314) 736-4275
(314) 260-6781
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
LC1370973
MO
Other
Enumeration date
04/14/2014
Last updated
04/14/2014
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