Individual
LATOYA SHAWNTEE GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
809 N 4TH ST STE B, MONROE, LA 71201-5964
(318) 884-7347
Mailing address
809 N 4TH ST STE B, MONROE, LA 71201-5964
(318) 884-7347
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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