Latiesha Colise James
Contractor in Decatur, GA. Individual provider (NPI-1).
NPI number1821557265
StatusActive
Last updated in NPPESMar 15, 2019
Details
- NPI
- 1821557265
- Entity type
- Individual (NPI-1)
- Name
- Latiesha Colise James
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 15, 2019
- Last updated
- Mar 15, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171W00000X | Contractor | 171W00000X | GA | Yes |
| 171W00000X | Contractor | – | GA |
Other names
- Latiesha Colise Butts (Former Name)
Practice location
2529 Terrace TrlDecatur, GA 30035-3514
Phone 334-947-7488
Mailing address
Po Box 683Gray, GA 31032-0683
Phone 678-531-3452
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