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Individual

LATASHIA BROWN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
28 N WEST AVE, BOURBONNAIS, IL 60914-1023
(815) 304-5534
Mailing address
28 N WEST AVE, BOURBONNAIS, IL 60914-1023
(815) 304-5534

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
B35053880808
IL

Other

Enumeration date
11/25/2009
Last updated
11/25/2009
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