Individual
TRACEY JUDITH LATIA SENIOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
4104 ORCHARD DALE DR NW APT N, CANTON, OH 44709-2095
(716) 510-4216
Mailing address
4104 ORCHARD DALE DR NW APT N, CANTON, OH 44709-2095
(716) 510-4216
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
602837170524
OH
Other
Enumeration date
08/13/2024
Last updated
08/13/2024
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