Individual
LATONYA A WHITE-UPCHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4025 W GIRARD AVE, PHILADELPHIA, PA 19104-1031
(267) 266-1339
Mailing address
4025 W GIRARD AVE, PHILADELPHIA, PA 19104-1031
(267) 266-1339
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
09/09/2022
Last updated
09/09/2022
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