MEDICARE: SHEILA JAFARIAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	005083	MO

General Provider Information

NPI Number	:	1558782037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEILA JAFARIAN

Provider Business Mailing Address
First Line	:	68 WILLOW BROOK DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63146-5679
Country	:	US
Telephone Number	:	314-323-2804
Fax Number	:

Provider Business Practice Location Address
First Line	:	68 WILLOW BROOK DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63146-5679
Country	:	US
Telephone Number	:	314-323-2804
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2013
Last Update Date	:	12/30/2013

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Directions to “ SHEILA JAFARIAN ” Practice Location

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