Individual
REBECCA AKU MAWUENYEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
11628 OLD BALLAS RD STE 227, CREVE COEUR, MO 63141-7030
(314) 607-2603
Mailing address
12982 NANCY LEE DR, SAINT LOUIS, MO 63146-4374
(314) 256-9732
(314) 256-9732
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
2007019763
MO
183500000X
Pharmacist
Primary
2007019763
MO
183500000X
Pharmacist
RP00006654
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
350063271
—
MO
Enumeration date
03/30/2012
Last updated
03/04/2019
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