NPI 1235706607

Latashanna Lavallais-Madison, MALE

Practitioner Prevention Professional Denver, CO

Practice location

Address: 3955 E Exposition Ave STE 320, Denver, CO 80209-5033
Phone: (303) 777-1151

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence COZ.0708525 (CO)

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Registry record

NPI: 1235706607
Entity type: Individual
Sex (as registered): Female
NPI issued: 4 Jun 2021
Record last updated: 4 Jun 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.