Individual
NICOLE LATHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
235 W AIRPORT BLVD, PENSACOLA, FL 32505-2239
(800) 857-5400
Mailing address
1519 MONROE ST, ALEXANDRIA, LA 71301-7149
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
01/19/2010
Last updated
01/19/2010
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