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Individual

LATRESSE DAWSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6702 DITMAN ST, PHILADELPHIA, PA 19135-2222
(267) 595-0178
Mailing address
6702 DITMAN ST, PHILADELPHIA, PA 19135-2222
(267) 595-0178

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
32613601

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
820742456
HOME CARE
PA
Enumeration date
06/27/2017
Last updated
07/21/2022
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