Individual
LATARSHA GAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
395 W BROADWAY, BOSTON, MA 02127-2275
(857) 496-5095
Mailing address
395 W BROADWAY, BOSTON, MA 02127-2275
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
LN97558
MA
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
11/07/2024
Last updated
11/07/2024
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