Individual
LATASHA YVETTE FENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
320 ASTER LN, GAHANNA, OH 43230-3549
(419) 806-7706
Mailing address
320 ASTER LN, GAHANNA, OH 43230-3549
(419) 806-7706
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
1487476040
OH
Other
Enumeration date
10/25/2024
Last updated
10/25/2024
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