Individual
EBONY CASSANDRA SUDDUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, PMHNP-BC
Contact information
Practice address
3824 S GRAND BLVD, SAINT LOUIS, MO 63118-3412
(314) 814-8180
Mailing address
10200 CEDARHURST DR, SAINT LOUIS, MO 63136-5616
(636) 628-5801
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2025041043
MO
Other
Enumeration date
10/06/2025
Last updated
03/16/2026
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