JELYA INGRID FATAWU

WENTZVILLE, MO
NPI1184331902
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: MO  2022035166)
Enumeration Date2022-11-01
Last Update Date2022-11-01
Business Address
Ms. JELYA INGRID FATAWU PMHMP-BC
4 LIBERTY GROVE CT
WENTZVILLE, MO 63385-7188
Phone number: 216-246-5697
Mailing Address
Ms. JELYA INGRID FATAWU PMHMP-BC
4 LIBERTY GROVE CT
WENTZVILLE, MO 63385-7188
Phone number:
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