Individual
LATISHA WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
321 LAVENDER LN, VIRGINIA BEACH, VA 23462-2608
(619) 961-9111
Mailing address
321 LAVENDER LN, VIRGINIA BEACH, VA 23462-2608
(619) 961-9111
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131002685
VA
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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