Individual
LATASHIA WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5502 E 38TH ST STE D, INDIANAPOLIS, IN 46218-1874
(317) 653-7610
Mailing address
4450 N KENYON AVE, INDIANAPOLIS, IN 46226-3588
(317) 653-7610
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
24-016786-1
IN
Other
Enumeration date
08/24/2024
Last updated
08/24/2024
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