Individual
LATASIA SARGENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1204 ENCHANTED FOREST ST, SOUTH BEND, IN 46637-4711
(574) 366-2330
Mailing address
1204 ENCHANTED FOREST ST, SOUTH BEND, IN 46637-4711
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SWB-2023-0312
NM
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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