Individual
GLADYS DESVARIEUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
907 GILHAM ST, PHILADELPHIA, PA 19111-5417
(267) 298-9092
Mailing address
907 GILHAM ST, PHILADELPHIA, PA 19111-5417
(267) 298-9092
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN276670
PA
Other
Enumeration date
12/04/2020
Last updated
12/04/2020
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