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Individual

MISS MAISHA LATIMER-SPORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
B.A.

Contact information

Practice address
11 CIRCLE AVENUE, LYNN, MA 01905
(781) 595-2413
(781) 598-0210
Mailing address
11 CIRCLE AVENUE, LYNN, MA 01905
(781) 595-2413
(781) 598-0210

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
04/12/2007
Last updated
07/08/2007
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