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1629795315
LATONYA LIDGE
JAMAICA, NY
NPI
1629795315
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY 33326-T)
Enumeration Date
2022-10-24
Last Update Date
2022-11-29
Business Address
LATONYA LIDGE
9002 161ST ST
JAMAICA, NY 11432-6108
Phone number: 718-520-1513
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Mailing Address
LATONYA LIDGE
3412 113TH ST # 2
CORONA, NY 11368-1425
Phone number:
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