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Individual

LATISHA J SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
122 LONG RIDGE DR, COLUMBIA, SC 29229-9230
(215) 900-7628
Mailing address
2715 COLONIAL DR STE 100B, COLUMBIA, SC 29203-6818
(803) 898-4802
(803) 898-4007

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
46442
SC

Other

Enumeration date
03/08/2018
Last updated
09/29/2025
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