Individual
LATYSHA LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
244 W GIRARD AVE, PHILADELPHIA, PA 19123-1777
(215) 725-2496
(215) 725-3241
Mailing address
8714 GLENLOCH ST, PHILADELPHIA, PA 19136-2115
(267) 353-5092
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/23/2021
Last updated
02/23/2021
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