Individual
TASHA LASANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
903 KILGORE ST, WILDWOOD, FL 34785-3950
(352) 748-0328
Mailing address
903 KILGORE ST, WILDWOOD, FL 34785-3950
(352) 748-0328
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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