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Individual

LATAVIA LACEFIELD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MENTAL HEALTH TECH

Contact information

Practice address
3903 INDIANAPOLIS BLVD, EAST CHICAGO, IN 46312-2555
(219) 473-1350
(219) 392-6998
Mailing address
8400 LOUISIANA ST, MERRILLVILLE, IN 46410-6385
(219) 757-1932
(219) 757-1950

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary

Other

Enumeration date
01/31/2011
Last updated
01/31/2011
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