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Contact Information

ANDREA CLARK, RD, LD
1 CHILDRENS PL
FOOD AND NUTRITION LS-15
SAINT LOUIS, MO63110-1002
 Phone: 314-454-2648
 Fax: 314-454-2557
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nutrition, Pediatric

133VN1004X 71 Registered Dietitian or Nutrition Professional
Indicates primary specialty

NPI Profile & details for ANDREA CLARK · (Female)

NPI # 1063863959
Status Active
Credentials RD, LD
Entity Individual
Enumeration date 06/22/2016
Last updated 06/22/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 133VN1004X
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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