Individual
ANGELA HAAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDS,CSA,CDP
Contact information
Practice address
1361 CHILDRESS AVE, SAINT LOUIS, MO 63139-3451
(314) 277-0851
Mailing address
PO BOX 220053, KIRKWOOD, MO 63122
(314) 277-0851
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G200131024
CDP
—
Enumeration date
05/26/2018
Last updated
06/16/2018
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