MEDICARE: JAMILA OWENS-TODD NATUROPATHIC DOCTOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3146774041	OTHER	MO	PRIVATE HEALTH INSURANCE

General Provider Information

NPI Number	:	1417612946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMILA OWENS-TODD NATUROPATHIC DOCTOR

Provider Business Mailing Address
First Line	:	3426 1/2 INDIANA AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63118-3233
Country	:	US
Telephone Number	:	314-320-0237
Fax Number	:

Provider Business Practice Location Address
First Line	:	3426 1/2 INDIANA AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63118-3233
Country	:	US
Telephone Number	:	314-320-0237
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2021
Last Update Date	:	10/31/2021

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