Deangelo Leon Mardis Valid NPI

Individual provider · Clinical Social Worker · Saint Louis, MO

NPI

1104687219

Type

Individual (Type 1)

Primary specialty

Clinical Social Worker (Social Worker)

Specialty group

Behavioral Health & Social Service Providers

Taxonomy code

1041C0700X

Sex

Male

Sole proprietor

No

Enumerated

2024-01-17

Last updated

2024-01-17