Individual
CHRISSY LYNN IMMKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1430 OLIVE ST, SAINT LOUIS, MO 63103-2303
(314) 206-3700
Mailing address
1430 OLIVE ST, SAINT LOUIS, MO 63103-2303
(314) 206-3700
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
11/02/2007
Last updated
11/02/2007
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