Healthcare Provider Details

I. General information

NPI: 1467100545
Provider Name (Legal Business Name): RAINEY HORWITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2022
Last Update Date: 03/16/2022
Certification Date: 03/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 S GRAND BLVD APT 320
SAINT LOUIS MO
63104-1016
US

IV. Provider business mailing address

4041 CHOUTEAU AVE APT 320
SAINT LOUIS MO
63110-1729
US

V. Phone/Fax

Practice location:
  • Phone: 314-795-0731
  • Fax:
Mailing address:
  • Phone: 314-795-0731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: