Individual
ELISSA LANETHARP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
343 S KIRKWOOD RD STE 200, SAINT LOUIS, MO 63122-6195
(314) 807-8909
Mailing address
343 SOUTH KIRKWOOD RD, ST LOUIS, MO 63122
(314) 807-8909
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/10/2014
Last updated
11/10/2014
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