Individual
LATOYA CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3325 WASHBURN AVE, CHARLOTTE, NC 28205-7024
(704) 340-4414
Mailing address
2226 WATERS TRAIL DR, CHARLOTTE, NC 28216-8800
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
NC
Other
Enumeration date
05/05/2020
Last updated
05/05/2020
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