Provider Demographics
NPI:1063200319
Name:FOREMAN, DAMEISHA LA'TREASE
Entity type:Individual
Prefix:MRS
First Name:DAMEISHA
Middle Name:LA'TREASE
Last Name:FOREMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 OAK RED CT
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-9074
Mailing Address - Country:US
Mailing Address - Phone:419-708-0879
Mailing Address - Fax:
Practice Address - Street 1:305 OAK RED CT
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-9074
Practice Address - Country:US
Practice Address - Phone:419-708-0879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH172A00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No172A00000XOther Service ProvidersDriver