Individual
LAKISHA TOWANDA STREATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMBT 10697
Contact information
Practice address
112 S GREEN ST, WADESBORO, NC 28170-2781
(704) 690-3597
Mailing address
112 S GREEN ST, WADESBORO, NC 28170-2781
(704) 690-3597
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10697
NC
Other
Enumeration date
07/01/2014
Last updated
07/17/2014
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