Individual
MS. LATRESA SHAWNITHA YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1604 E 29TH AVE, TAMPA, FL 33605-1124
(813) 966-2127
Mailing address
1604 E 29TH AVE, TAMPA, FL 33605-1124
(813) 966-2127
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
FL
Other
Enumeration date
12/02/2025
Last updated
12/02/2025
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