Individual
LATISHA WORMELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS, LDN
Contact information
Practice address
400 S 4TH ST STE 500, LAS VEGAS, NV 89101-6207
(702) 708-1686
Mailing address
200 QUAIL RUN, GOLDSBORO, NC 27530-9250
(623) 512-9236
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
DX6087
MD
Other
Enumeration date
05/05/2023
Last updated
05/05/2023
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