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Individual

TAWANA LATRICE AUSTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
37 E DELMAR AVE, ALTON, IL 62002-5903
(314) 706-2854
(314) 228-0252
Mailing address
37 E DELMAR AVE, ALTON, IL 62002-5903
(314) 706-2854
(314) 228-0252

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
261QA0600X
Adult Day Care Clinic/Center
Primary

Other

Enumeration date
12/02/2025
Last updated
12/02/2025
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