Individual
LISSET FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 PARK AVE, SAINT LOUIS, MO 63104-3024
(866) 626-2878
(314) 588-8437
Mailing address
1500 PARK AVE, SAINT LOUIS, MO 63104-3024
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/30/2024
Last updated
01/30/2024
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