Individual
MRS. SUZANNE M LATAILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAT
Contact information
Practice address
47 JAMES F BYRNES ST, BEAUFORT, SC 29907-1940
(843) 525-0023
Mailing address
47 JAMES F BYRNES ST, BEAUFORT, SC 29907-1940
(843) 525-0023
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
08/16/2012
Last updated
08/16/2012
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