Individual
LETASHA DIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4099 CALAVERA DR, FLORISSANT, MO 63033-6632
(314) 723-0659
Mailing address
4099 CALAVERA DR, FLORISSANT, MO 63033-6632
(314) 723-0659
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
2020002382
MO
Other
Enumeration date
09/02/2020
Last updated
09/02/2020
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