Individual
LATORYA LANIECE WILLINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
1435 W HADLEY ST, MILWAUKEE, WI 53206-2649
(414) 807-1223
Mailing address
1435 W HADLEY ST, MILWAUKEE, WI 53206-2649
(414) 807-1223
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/12/2015
Last updated
06/12/2015
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