Individual
LATOSHA SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4319 PHILADELPHIA DR, DAYTON, OH 45405-1928
(190) 164-4881
Mailing address
4319 PHILADELPHIA DR, DAYTON, OH 45405-1928
(901) 644-8814
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
RS533003
OH
251X00000X
Supports Brokerage Agency
5718684
OH
3747P1801X
Personal Care Attendant
5718684
OH
376J00000X
Homemaker
Primary
5718684
OH
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
5718684
OH
Other
Enumeration date
06/03/2024
Last updated
06/03/2024
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