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1306417142
LATASHIA N PETTIFORD
BALTIMORE, MD
NPI
1306417142
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MD 2967)
Enumeration Date
2021-07-02
Last Update Date
2021-07-02
Business Address
Miss LATASHIA N PETTIFORD CAC-AD
6207 BELAIR RD
BALTIMORE, MD 21206-1942
Phone number: 443-835-2681
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Mailing Address
Miss LATASHIA N PETTIFORD CAC-AD
6900 EASTBROOK AVE
BALTIMORE, MD 21224-1839
Phone number: 443-226-0310
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