Individual
LATIAHA NICHELLE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
INTERCOMMUNITY, INC, 281 MAIN STREET, EAST HARTFORD, CT 06118
(860) 569-5900
Mailing address
86 SUMMER HILL RD, MIDDLETOWN, CT 06457-5646
(860) 710-3104
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11062
CT
Other
Enumeration date
10/13/2022
Last updated
10/13/2022
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