Individual
STEPHANIE MINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
900 ROYAL HEIGHTS RD, BELLEVILLE, IL 62226-5457
(618) 688-1171
Mailing address
900 ROYAL HEIGHTS RD, BELLEVILLE, IL 62226-5457
(618) 688-1181
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/26/2020
Last updated
08/26/2020
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