Sharold Neasha Wallace
Pharmacy Technician in Ferguson, MO. Individual provider (NPI-1).
NPI number1386353084
StatusActive
Last updated in NPPESNov 21, 2022
Details
- NPI
- 1386353084
- Entity type
- Individual (NPI-1)
- Name
- Sharold Neasha Wallace
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 21, 2022
- Certification date
- Nov 21, 2022
- Last updated
- Nov 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183700000X | Pharmacy Technician | 2001021627 | MO | Yes |
Practice location
190 N Florissant RdFerguson, MO 63135-1942
Phone 314-521-4518
Mailing address
190 N Florissant RdFerguson, MO 63135-1942
Phone 314-521-4518
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