Individual
TINA TURNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1150 GRAHAM RD STE 102, FLORISSANT, MO 63031-8077
(314) 332-5414
Mailing address
1150 GRAHAM RD STE 102, FLORISSANT, MO 63031-8077
(314) 332-5414
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/06/2024
Last updated
02/06/2024
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