Individual
LATASHA M COLEMAN-FAIRLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3226 BECKER GLEN ST, FRESNO, TX 77545-7007
(629) 395-2185
Mailing address
22 CENTURY BLVD STE 220, NASHVILLE, TN 37214-3787
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
64389
TX
Other
Enumeration date
03/29/2022
Last updated
03/29/2022
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