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Individual

KENDRA BALLESTEROS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.A.

Contact information

Practice address
11960 WESTLINE INDUSTRIAL DRIVE #201, ST. LOUIS, MO 63146-3209
(314) 890-0480
Mailing address
11960 WESTLINE INDUSTRIAL DR STE 201, SAINT LOUIS, MO 63146-3209

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
2003029643
MO

Other

Enumeration date
04/08/2015
Last updated
04/08/2015
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