Individual
LATARSHA MONIQUE ELLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1327 WASHINGTON BLVD, BALTIMORE, MD 21230-1828
(443) 400-4275
Mailing address
3011 FALLSTAFF MANOR CT APT D, BALTIMORE, MD 21209-2829
(443) 400-4275
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
25435
MD
Other
Enumeration date
01/11/2021
Last updated
01/11/2021
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