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Individual

MS. LATWANSHREE QUEEN KIDD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
21 W OWENS AVE, NORTH LAS VEGAS, NV 89030-6817
(323) 817-8558
Mailing address
21 W OWENS AVE, NORTH LAS VEGAS, NV 89030-6817
(323) 817-8558

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist

Other

Enumeration date
10/24/2014
Last updated
10/24/2014
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