Healthcare Provider Details

I. General information

NPI: 1720004047
Provider Name (Legal Business Name): JANET E HEATH MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 S KINGSHIGHWAY BLVD
SAINT LOUIS MO
63108-1301
US

IV. Provider business mailing address

C B 8221 7425 FORSYTH
SAINT LOUIS MO
63105-2161
US

V. Phone/Fax

Practice location:
  • Phone: 314-286-1700
  • Fax: 314-286-1777
Mailing address:
  • Phone: 314-286-1700
  • Fax: 314-286-1777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number005322
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: