Individual
DELORES ARDITH ELENA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
10448 W FLORISSANT AVE, SAINT LOUIS, MO 63136-2343
(314) 867-8865
(314) 867-8079
Mailing address
10448 W FLORISSANT AVE, SAINT LOUIS, MO 63136-2343
(314) 867-8865
(314) 867-8079
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
026190
MO
Other
Enumeration date
11/25/2008
Last updated
11/25/2008
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