Individual
LATESHIA WINGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1915 EBENEZER RD, ROCK HILL, SC 29732-1013
(803) 431-4236
Mailing address
706 BALBOA CT, FORT MILL, SC 29715-5008
(803) 431-4236
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3644
SC
Other
Enumeration date
10/03/2017
Last updated
10/03/2017
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