Provider Demographics
NPI:1154179349
Name:HAMBRICK, LATASHA
Entity type:Individual
Prefix:
First Name:LATASHA
Middle Name:
Last Name:HAMBRICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1436 MARLOWE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224-3060
Mailing Address - Country:US
Mailing Address - Phone:513-338-3735
Mailing Address - Fax:
Practice Address - Street 1:1436 MARLOWE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224-3060
Practice Address - Country:US
Practice Address - Phone:513-338-3735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-11
Last Update Date:2024-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health