Individual
LATASHA DYNETTE CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RMA
Contact information
Practice address
262 E UNIVERSITY DR, MESA, AZ 85201-5932
(602) 599-5642
(602) 808-2712
Mailing address
202 E EARLL DR, SUITE 200, PHOENIX, AZ 85012-2647
(602) 599-5404
(602) 599-5704
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
11/07/2014
Last updated
11/07/2014
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