Individual
LATRICE BURGOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
1 MEDICAL CENTER BLVD, CHESTER, PA 19013-3902
(610) 619-8420
Mailing address
518 EAST 23RD STREET, CHESTER, PA 19013
(484) 557-3008
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/04/2015
Last updated
08/11/2022
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