Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LATAVIA LACEFIELD, MENTAL HEALTH TECH
Active Sole ProprietorLATAVIA LACEFIELD, MENTAL HEALTH TECH is a Medical Physician Assistant healthcare provider located in EAST CHICAGO, Indiana. NPI 1275839870 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · EAST CHICAGO, IN
Registration Details
- NPI Number
- 1275839870
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 31, 2011 (15.580832737549 yrs)
- Last Updated
- Jan 31, 2011
- Sole Proprietor
- Yes
Practice Information
- Address
-
3903 INDIANAPOLIS BLVDEAST CHICAGO, IN, 463122555Browse IN providers · Browse ZIP 46312
- Phone
- 2194731350
- Fax
- 2193926998
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
Other Medical Physician Assistant Providers in EAST CHICAGO, IN
| Name | Credential | NPI |
|---|---|---|
| MICHAEL MADDOX | MENTAL HEALTH TECH | 1568768158 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.