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Individual

MS. BIANCA GIST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
12 N SARAH ST., SAINT LOUIS, MO 63108-2817
(636) 800-2401
(636) 800-2402
Mailing address
12 N. SARAH ST., SAINT LOUIS, MO 63108-2817
(636) 800-2401
(636) 800-2402

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18571
MO
246RM2200X
Medical Laboratory Technician
246RP1900X
Phlebotomy Technician
MO

Other

Enumeration date
01/04/2023
Last updated
01/05/2026
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