Individual provider · NPI-1

Shawn Donnika Sotofalcon

Technician/Technologist · Florissant, MO

NPI number1992269104
StatusActive
Last updated in NPPESJan 22, 2019

Details

NPI
1992269104
Entity type
Individual (NPI-1)
Name
Shawn Donnika Sotofalcon
Sex
Female
Sole proprietor
Yes
Enumeration date
Jan 22, 2019
Last updated
Jan 22, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
156F00000X Technician/Technologist0000000MOYes

Practice location

11921 Cato Dr
Florissant, MO 63033-6903

Phone 314-346-8520

Mailing address

11921 Cato Dr
Florissant, MO 63033-6903

Phone 314-346-8520

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