Individual
MRS. CYNTHIA ANN BABCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1167 WINTER PARK DR, FENTON, MO 63026-5696
(636) 349-5886
Mailing address
1167 WINTER PARK DR, FENTON, MO 63026-5696
(636) 349-5886
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
R1209
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R1209
MISSOURI STATE BOARD OF HEALING ARTS
MO
Enumeration date
09/18/2009
Last updated
09/18/2009
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