Healthcare Provider Details

I. General information

NPI: 1457865552
Provider Name (Legal Business Name): DEBBIE CATHY YEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2017
Last Update Date: 11/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12647 OLIVE BLVD STE 600
SAINT LOUIS MO
63141-6346
US

IV. Provider business mailing address

12647 OLIVE BLVD STE 600
SAINT LOUIS MO
63141-6346
US

V. Phone/Fax

Practice location:
  • Phone: 800-325-3982
  • Fax: 877-685-9880
Mailing address:
  • Phone: 800-325-3982
  • Fax: 877-685-9880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH236701
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: