Individual
LAVONSHEA ATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4002 APPLEBERRY LN, SAINT LOUIS, MO 63121-3701
(314) 853-1766
Mailing address
4002 APPLEBERRY LN, SAINT LOUIS, MO 63121-3701
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
052690
—
MO
Enumeration date
12/11/2020
Last updated
12/11/2020
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