| NPI | 1861938912 |
|---|---|
| Former Name | LATARSIA RENEE DAVIS, ROUNDTREE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2017-01-13 |
| Last Update Date | 2019-01-09 |