| NPI | 1467684258 |
|---|---|
| Former Name | LATISHA T PENNYWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: LA 8348) |
| Additional Taxonomies | 104100000X Social Worker (Licence: LA 8348) |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2023-10-06 |