Individual provider · Type 1 NPI

Latavia Lacefield, MENTAL HEALTH TECH

Medical Physician Assistant · East Chicago, IN

NPI number 1275839870 Active

Practice location

3903 Indianapolis Blvd
East Chicago, IN 46312-2555

Fax (219) 392-6998

Mailing address

8400 Louisiana St
Merrillville, IN 46410-6385

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1275839870

Latavia Lacefield, MENTAL HEALTH TECH's National Provider Identifier is 1275839870, issued on Jan 31, 2011. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in East Chicago, IN. The record was last updated on Jan 31, 2011.