Individual
LYDIA L. HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6339
(314) 251-4564
Mailing address
1591 HIGHLAND VALLEY CIR, WILDWOOD, MO 63005-4263
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2025032287
MO
Other
Enumeration date
06/06/2025
Last updated
08/20/2025
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