Individual
JYOTHI MANDAVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
16091 SWINGLEY RIDGE RD STE 100, CHESTERFIELD, MO 63017-2056
(636) 778-1195
(636) 898-1019
Mailing address
16091 SWINGLEY RIDGE RD STE 100, CHESTERFIELD, MO 63017-2056
(636) 778-1195
(636) 898-1019
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2002002075
MO
Other
Enumeration date
08/19/2006
Last updated
08/16/2023
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