Individual
MISS REBECCA MAE WAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 HOLY GRAIL CT, SAINT LOUIS, MO 63125
(314) 402-3125
Mailing address
1001 HOLY GRAIL CT, SAINT LOUIS, MO 63125
(314) 402-3125
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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