Individual
SHOWNA WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2242 BERWYN DR, SAINT LOUIS, MO 63136-5415
(314) 223-2039
Mailing address
2242 BERWYN DR, SAINT LOUIS, MO 63136-5415
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
113405
MO
Other
Enumeration date
11/12/2018
Last updated
11/12/2018
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