Individual
LATISHA RACHELLE BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
370 FENBROOK WAY SW # 30064, MARIETTA, GA 30064-1680
(425) 465-8440
Mailing address
370 FENBROOK WAY SW, MARIETTA, GA 30064-1680
(425) 465-8440
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
—
GA
103TH0100X
Health Service Psychologist
—
—
Other
Enumeration date
04/30/2022
Last updated
04/30/2022
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