Individual
EMONA LASHELLE EWHAREKUKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2162 CHERRY AVE, SAINT LOUIS, MO 63121-5625
(314) 526-1352
Mailing address
2162 CHERRY AVE, SAINT LOUIS, MO 63121-5625
(314) 526-1352
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
S137338040
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47-1693138
—
MO
01
—
47-1693183
BLUE CROSS, BLUE SHIELD, AETNA, KAISER-PERMANENTE, ETC
MO
05
—
47-1693183
—
MO
Enumeration date
11/25/2014
Last updated
11/26/2014
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