Individual
LATONYA THEDFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
745 CRAIG RD STE 208C, CREVE COEUR, MO 63141-7122
(314) 215-9574
Mailing address
1139 HILLTOP DR, SAINT LOUIS, MO 63132-2416
(314) 215-9574
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
07/15/2021
Last updated
07/15/2021
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