Individual
MIISHA OWENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2529 HACKMAN DR, SAINT LOUIS, MO 63136-5836
(314) 372-9446
Mailing address
2529 HACKMAN DR, SAINT LOUIS, MO 63136-5836
(314) 372-9446
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
001532409
MO
Other
Enumeration date
03/30/2017
Last updated
03/30/2017
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