Individual
LASHAWNDA C GASTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1322 LE MAR DR, CINCINNATI, OH 45238
(513) 817-6714
Mailing address
1322 LE MAR DR, CINCINNATI, OH 45238
(513) 817-6714
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
313036561601
—
OH
Enumeration date
01/27/2016
Last updated
01/27/2016
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