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1366209678
LATOSHA SHANTA LAKE
LORAIN, OH
NPI
1366209678
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Former Name
LATOSHA LAKE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
251K00000X Public Health or Welfare
Enumeration Date
2024-03-04
Last Update Date
2024-03-04
Business Address
Mrs. LATOSHA SHANTA LAKE
1424 REDBUD PL
LORAIN, OH 44053-3147
Phone number: 440-597-8150
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Mailing Address
Mrs. LATOSHA SHANTA LAKE
1424 REDBUD PL
LORAIN, OH 44053-3147
Phone number: 440-597-8150
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