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1366999757
LATISHA ELLIS
COVINGTON, LA
NPI
1366999757
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2016-09-02
Last Update Date
2016-09-02
Business Address
-- LATISHA ELLIS
19331 N 12TH ST
COVINGTON, LA 70433-5228
Phone number: 985-400-5901
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Mailing Address
-- LATISHA ELLIS
19331 N 12TH ST
COVINGTON, LA 70433-5228
Phone number: 985-400-5901
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