Latisha Shaw

NPI #1932972114 in Huntington Park, California

Provider Information

NPI Number: 1932972114
Entity Type: Individual
Name: Latisha Shaw
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Peer Specialist
Enumeration Date: Oct 31, 2023
Last Updated: Oct 31, 2023

Practice Location

Address: 2677 ZOE AVE STE 304
City: Huntington Park
State: California
ZIP Code: 90255-3699
Phone: (323) 346-0960

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Rehabilitation Practitioner	225400000X
Peer Specialist	175T00000X	Primary

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