Individual
KATHLEEN K THAMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12855 N 40 DR, SUITE 350, SAINT LOUIS, MO 63141-8657
(314) 205-1926
(314) 205-1076
Mailing address
12855 N 40 DR, SUITE 350, SAINT LOUIS, MO 63141-8657
(314) 205-1926
(314) 205-1076
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
20040298088
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20040298088
LICENSE
MO
Enumeration date
08/31/2010
Last updated
08/31/2010
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