Provider Demographics
NPI:1386442663
Name:LEMOINE, LAETITIA
Entity type:Individual
Prefix:
First Name:LAETITIA
Middle Name:
Last Name:LEMOINE
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 1:214 S COLLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-2627
Mailing Address - Country:US
Mailing Address - Phone:202-317-1586
Mailing Address - Fax:
Practice Address - Street 1:214 S COLLINGTON AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231-2627
Practice Address - Country:US
Practice Address - Phone:202-317-1586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program