Individual
LATONYA ISAIAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3116 EADS AVE, SAINT LOUIS, MO 63104-1430
(314) 306-5433
Mailing address
3116 EADS AVE, SAINT LOUIS, MO 63104-1430
(314) 306-5433
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
LC1748396
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
854279826
—
MO
Enumeration date
12/15/2020
Last updated
12/15/2020
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