Individual
YOLANDA MICHELLE GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1558 16TH ST S, ST PETERSBURG, FL 33705-2448
(727) 687-2672
Mailing address
1558 16TH ST S, ST PETERSBURG, FL 33705-2448
(727) 687-2672
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
39971602
FL
376J00000X
Homemaker
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
UNK
FL
—
Enumeration date
04/09/2020
Last updated
04/09/2020
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