Healthcare Provider Details

I. General information

NPI: 1659212850
Provider Name (Legal Business Name): TASTE OF SUCCESS COACHING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8332 CORNELL AVE
SAINT LOUIS MO
63132-5026
US

IV. Provider business mailing address

8332 CORNELL AVE
SAINT LOUIS MO
63132-5026
US

V. Phone/Fax

Practice location:
  • Phone: 314-623-2226
  • Fax:
Mailing address:
  • Phone: 314-623-2226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: LARRY A JONES
Title or Position: PRESIDENT / OWNER
Credential:
Phone: 314-623-2226