Individual
MS. TEIRA QUANTAYE WORTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4218 N GRAND BLVD, SAINT LOUIS, MO 63107-1806
(314) 243-8236
Mailing address
4218 N GRAND BLVD, SAINT LOUIS, MO 63107-1806
(314) 243-8236
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/23/2017
Last updated
02/23/2017
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