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Individual

LATISHA KEITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7116 FORT HUNT RD, ALEXANDRIA, VA 22307-1900
(703) 768-0234
(703) 768-2697
Mailing address
6456 BLARNEY STONE CT, SPRINGFIELD, VA 22152-2108

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119003784
VA

Other

Enumeration date
04/02/2007
Last updated
03/08/2010
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