Individual
AMANDA LATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM, CPM
Contact information
Practice address
33690 ALMOND ST, WILDOMAR, CA 92595-8752
(951) 704-4145
Mailing address
33690 ALMOND ST, WILDOMAR, CA 92595-8752
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
LM618
CA
Other
Enumeration date
10/01/2020
Last updated
10/01/2020
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