Individual
LOLA ANN GUNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4220 N GRAND BLVD, SAINT LOUIS, MO 63107-1831
(314) 664-7600
Mailing address
4220 N GRAND BLVD, SAINT LOUIS, MO 63107-1831
(314) 664-7600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4719
MO
Other
Enumeration date
07/05/2018
Last updated
07/05/2018
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