| NPI | 1598270381 |
|---|---|
| Former Name | LATRESE WILBOURN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2017-12-03 |
| Last Update Date | 2025-01-30 |