Individual
BREAUNA LATRICE DENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
837 N 73RD ST, EAST SAINT LOUIS, IL 62203-1713
(618) 514-2064
Mailing address
837 N 73RD ST, EAST SAINT LOUIS, IL 62203-1713
(618) 514-2064
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
147827
MO
Other
Enumeration date
01/17/2024
Last updated
01/17/2024
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