Individual
LATASHA MARIE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
8501 SANTA ROSA AVE, BATON ROUGE, LA 70810-6999
(225) 207-2229
Mailing address
8501 SANTA ROSA AVE, BATON ROUGE, LA 70810-6999
(225) 207-2229
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
LA
Other
Enumeration date
01/09/2026
Last updated
01/09/2026
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