Individual
LATRICE S NEWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3315 SPRING MOUNTAIN RD, LAS VEGAS, NV 89102-8603
(702) 754-3484
Mailing address
10021 S WOOD ST, CHICAGO, IL 60643-2009
(312) 882-7224
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XOH836546548
BLUE CROSS BLUE SHIELD
IL
Enumeration date
11/19/2016
Last updated
11/19/2016
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