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General NPI Number Information
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NPI Number | 1609328996
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Entity Type | Individual
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Provider Name | GINA LAGARCE
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Gender | Female
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Dates
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Enumeration Date | 11/02/2016
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Last Update Date | 11/03/2016
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Provider Practice Location Address
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Address Line | 801 N. 11TH STREET ST. LOUIS PUBLIC SCHOOLS
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City | SAINT LOUIS
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State | MO
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Zip | 63107
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Country | US
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Telephone | 314-231-3720
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Fax |
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Provider Business Mailing Address
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Address Line | 4729 TIEMANN AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63123-5816
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Country | US
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Telephone | 636-346-7504
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State | MO
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