Individual
MRS. LATOSHA SHANTA LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1424 REDBUD PL, LORAIN, OH 44053-3147
(440) 597-8150
Mailing address
1424 REDBUD PL, LORAIN, OH 44053-3147
(440) 597-8150
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
03/04/2024
Last updated
03/04/2024
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