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Individual

MRS. LATASHA BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
235 E 103RD ST, CHICAGO, IL 60628-2807
(312) 371-3618
Mailing address
9405 S ADA ST, CHICAGO, IL 60620-3608
(773) 615-8805

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
IL

Other

Enumeration date
06/11/2019
Last updated
06/11/2019
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