Individual
TEPPIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1202 JOSEPHINE BAKER AVE, SAINT LOUIS, MO 63106-1667
(314) 687-9294
Mailing address
1202 JOSEPHINE BAKER AVE, SAINT LOUIS, MO 63106-1667
(314) 687-9294
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
LC014402238
MO
Other
Enumeration date
09/06/2024
Last updated
09/06/2024
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