Individual
LATONYA ROUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5214 VIA HACIENDA, 206, ORLANDO, FL 32839
(321) 437-2673
Mailing address
5214 VIA HACIENDA CIR APT 206, ORLANDO, FL 32839-2187
13214372673
(132) 143-7267
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/26/2017
Last updated
09/26/2017
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