Individual
MS. LATRICE A WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
417 FOUNTAIN ST, HAVRE DE GRACE, MD 21078-3207
(443) 616-7587
Mailing address
PO BOX 951, GLEN BURNIE, MD 21060-2951
(443) 766-8584
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
05/29/2009
Last updated
10/13/2017
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