Individual
SYDNEY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11102 LINDBERGH CT, SAINT LOUIS, MO 63123-7810
(314) 339-9663
Mailing address
1430 OLIVE ST STE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3700
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500-08-860
BS
MO
Enumeration date
03/20/2018
Last updated
03/20/2018
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