Individual
LATASHA MARIE PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5100 PEACH STREET, ERIE, PA 16509
(814) 866-4500
Mailing address
5100 PEACH STREET, ERIE, PA 16509
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW133856
PA
Other
Enumeration date
09/21/2017
Last updated
09/21/2017
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