Individual
LAQUETTA WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1121 E GANO AVE, SAINT LOUIS, MO 63107-1319
(314) 745-8125
Mailing address
1121 E GANO AVE, SAINT LOUIS, MO 63107-1319
(314) 745-8125
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
13024
MO
Other
Enumeration date
02/27/2018
Last updated
02/27/2018
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