Individual
LATETRIC LATAE WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8324 W CHARLESTON BLVD UNIT 2069, LAS VEGAS, NV 89117-9208
(702) 888-5196
Mailing address
8324 W CHARLESTON BLVD UNIT 2069, LAS VEGAS, NV 89117-9208
(702) 888-5196
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/28/2021
Last updated
04/28/2021
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