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General NPI Number Information
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NPI Number | 1598626657
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Entity Type | Organization
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Legal Business Name | RIVER SIRENS COLLECTIVE
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Dates
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Enumeration Date | 11/19/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 209 W 2ND ST
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City | WASHINGTON
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State | MO
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Zip | 63090-2132
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Country | US
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Telephone | 636-283-0437
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Fax |
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Provider Business Mailing Address
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Address Line | 209 W 2ND ST
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City | WASHINGTON
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State | MO
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Zip | 63090-2132
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Country | US
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Telephone | 636-283-0437
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. DELENE P. MUSIELAK
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Credential | MD,FACP,FAAP,DABOM
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Telephone | 314-377-2510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083B0002X
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Taxonomy Name | Obesity Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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