MRS. Latisha Shanta Lewis, M.A.T.
NPI #1013297431 in Belleville, Illinois
Provider Information
- NPI Number
- 1013297431
- Entity Type
- Individual
- Name
- MRS. Latisha Shanta Lewis, M.A.T.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Developmental Therapist
- Credential
- M.A.T.
- Enumeration Date
- Aug 17, 2011
- Last Updated
- Aug 17, 2011
Practice Location
- Address
- 1948 RICHMOND SPRINGS LN
- City
- Belleville
- State
- Illinois
- ZIP Code
- 62220-3283
- Phone
- (618) 402-4319
Specialties & Taxonomy Codes
| Specialty |
|---|
| Developmental Therapist |
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