Individual
LATRESA DEWBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
705 VIA BRAVO, MESQUITE, TX 75150-3017
(469) 879-3396
(214) 613-2592
Mailing address
705 VIA BRAVO, MESQUITE, TX 75150-3017
(469) 879-3396
(214) 613-2592
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
08/17/2010
Last updated
08/17/2010
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