Individual
MRS. SHYLA DAVON TIMES MAYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
3165 MCKELVEY RD, BRIDGETON, MO 63044-2550
(314) 800-5848
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
—
0606247560
SOCIAL WORKER
MO
Enumeration date
01/05/2018
Last updated
01/05/2018
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