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Individual

LATOISHANAI JETER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1515 KENSINGTON AVE, BUFFALO, NY 14215-1436
(716) 510-3645
Mailing address
236 ROSLYN ST, BUFFALO, NY 14215-3941
(716) 510-3645

Taxonomy

Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
171M00000X
Case Manager/Care Coordinator
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Enumeration date
08/11/2025
Last updated
08/11/2025
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