Individual
LATASHANNA LAVALLAIS-MADISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA,LE
Contact information
Practice address
3955 E EXPOSITION AVE STE 320, DENVER, CO 80209-5033
(303) 777-1151
Mailing address
3955 E EXPOSITION AVE STE 320, DENVER, CO 80209-5033
(303) 777-1151
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
COZ.0708525
CO
Other
Enumeration date
06/04/2021
Last updated
06/04/2021
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