Individual
JACQUELLA MARIE LATTIMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SWT
Contact information
Practice address
3737 LANDER RD, PEPPER PIKE, OH 44124
(216) 855-2179
Mailing address
3737 LANDER RD, PEPPER PIKE, OH 44124-5712
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
.1800414
OH
Other
Enumeration date
05/11/2018
Last updated
05/11/2018
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