Individual
LATESHA L WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAT
Contact information
Practice address
6143 186TH ST, FRESH MEADOWS, NY 11365-2710
(347) 349-5478
Mailing address
6143 186TH ST, FRESH MEADOWS, NY 11365-2710
(347) 349-5478
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
002155
NY
Other
Enumeration date
07/22/2020
Last updated
11/16/2020
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