Individual
LATASHA DANIELLE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5909 CABLE AVE, CLEVELAND, OH 44127-1745
(216) 230-4845
Mailing address
5909 CABLE AVE, CLEVELAND, OH 44127-1745
(216) 230-4845
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
850679012
—
OH
Enumeration date
11/25/2022
Last updated
11/25/2022
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