Shantae Johnson Latleif
Behavior Technician in Odenton, MD. Individual provider (NPI-1).
NPI number1982243770
StatusActive
Last updated in NPPESDec 27, 2019
Details
- NPI
- 1982243770
- Entity type
- Individual (NPI-1)
- Name
- Shantae Johnson Latleif
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 27, 2019
- Certification date
- Dec 27, 2019
- Last updated
- Dec 27, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Other names
- Shantae Johnson (Other Name)
Practice location
536 Greencrest LnOdenton, MD 21113-1486
Phone 410-841-8011
Mailing address
536 Greencrest LnOdenton, MD 21113-1486
Phone 410-841-8011
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