Individual
LASHONDA GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4084 90TH AVE, FLORISSANT, MO 63034-2132
(314) 915-5748
Mailing address
6439 PLYMOUTH AVE STE 108, SAINT LOUIS, MO 63133-1940
(314) 915-5748
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
02/01/2021
Last updated
12/09/2021
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