Individual
LATISHA HUMPHRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
750 PORT ST APT 204, ALEXANDRIA, VA 22314-2475
(412) 522-4006
Mailing address
750 PORT ST APT 229, ALEXANDRIA, VA 22314-2477
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/27/2017
Last updated
09/27/2017
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