Individual
KALA LATRALE OAKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PEER SPECIALIST
Contact information
Practice address
1099 JAY ST, ROCHESTER, NY 14611-1153
(585) 328-0740
Mailing address
1099 JAY ST, ROCHESTER, NY 14611-1153
(585) 328-0740
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
NYCPS-P-2102
NY
Other
Enumeration date
05/17/2019
Last updated
05/17/2019
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