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Individual

LATEEFAH LASHAWN NOEL KEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW, ST

Contact information

Practice address
320 WOODSIDE BLVD, FAYETTEVILLE, GA 30214-2550
(561) 516-0311
Mailing address
320 WOODSIDE BLVD, FAYETTEVILLE, GA 30214-2550
(561) 516-0311

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
061953364
GA

Other

Enumeration date
05/29/2024
Last updated
05/29/2024
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