Healthcare Provider Details

I. General information

NPI: 1932031242
Provider Name (Legal Business Name): CALIE RAE MOGRAN GRIFFITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1881 PINE ST
SAINT LOUIS MO
63103-2264
US

IV. Provider business mailing address

6756 DOLAN PL
SAINT LOUIS MO
63139-3741
US

V. Phone/Fax

Practice location:
  • Phone: 314-533-0975
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2024021987
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: