Individual
MRS. LATISHA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
952 STEVENSON RD, CLEVELAND, OH 44110-3176
(216) 466-7212
Mailing address
952 STEVENSON RD, CLEVELAND, OH 44110-3176
(216) 466-7212
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
0330433
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0330433
—
OH
Enumeration date
04/07/2020
Last updated
04/07/2020
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