Individual
LATISHIA PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8936 MAYFIELD CT, SAINT LOUIS, MO 63136-5054
(314) 724-5460
Mailing address
8936 MAYFIELD CT, SAINT LOUIS, MO 63136-5054
(314) 724-5460
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
07/12/2012
Last updated
07/12/2012
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