Individual
LATISHA CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
320 ELDRED AVE, TOLEDO, OH 43609-2135
(419) 810-2230
Mailing address
320 ELDRED AVE, TOLEDO, OH 43609-2135
(419) 810-2230
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
400676531007
OH
Other
Enumeration date
06/11/2014
Last updated
06/11/2014
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