Individual
LAKESHA TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 12TH STREET EXT, PRINCETON, WV 24740-2329
(304) 425-9541
Mailing address
709 STRALEY AVE APT 8, PRINCETON, WV 24740-3162
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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