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Individual

MISHLA LATICE HOLMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
3165 MCKELVEY RD, BRIDGETON, MO 63044-2563
(314) 206-3900
Mailing address
1430 OLIVE ST STE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3700

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
08/07/2018
Last updated
08/07/2018
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