Provider Demographics
NPI:1538749452
Name:JONES, LATRESHA
Entity type:Individual
Prefix:
First Name:LATRESHA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 GENEVA DR
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-9732
Mailing Address - Country:US
Mailing Address - Phone:513-557-6990
Mailing Address - Fax:251-408-9330
Practice Address - Street 1:101 GENEVA DR
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-9732
Practice Address - Country:US
Practice Address - Phone:513-557-6990
Practice Address - Fax:251-408-9330
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty