LATISHA SHANTA LEWIS

BELLEVILLE, IL
NPI1013297431
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy222Q00000X Developmental Therapist
(Licence: IL  L200-5377-9925)
Enumeration Date2011-08-17
Last Update Date2011-08-17
Business Address
Mrs. LATISHA SHANTA LEWIS M.A.T.
1948 RICHMOND SPRINGS LN
BELLEVILLE, IL 62220-3283
Phone number: 618-402-4319
Mailing Address
Mrs. LATISHA SHANTA LEWIS M.A.T.
1948 RICHMOND SPRINGS LN
BELLEVILLE, IL 62220-3283
Phone number: 618-402-4319
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