MEDICARE: MARY CURLEE

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	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1548713985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY CURLEE

Provider Business Mailing Address
First Line	:	10021 CLAIRMONT DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-3112
Country	:	US
Telephone Number	:	314-245-3954
Fax Number	:	314-499-4358

Provider Business Practice Location Address
First Line	:	10021 CLAIRMONT DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-3112
Country	:	US
Telephone Number	:	314-245-3954
Fax Number	:	314-499-4358

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

Provider Enumeration Date	:	08/02/2016
Last Update Date	:	08/02/2016

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Directions to “ MARY CURLEE ” Practice Location

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