Individual
LATASHIA MICHELLE HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
346 MAGNOLIA ST, ROCHESTER, NY 14611-3708
(585) 705-7352
Mailing address
346 MAGNOLIA ST, ROCHESTER, NY 14611-3708
(585) 705-7352
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
22HE1242264
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22HE1242264
COSMETOLOGY LICENSE
NY
Enumeration date
06/11/2026
Last updated
06/11/2026
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