Provider Demographics
NPI:1447781240
Name:ASHCRAFT, LATISHA K (BC-HIS)
Entity Type:Individual
Prefix:
First Name:LATISHA
Middle Name:K
Last Name:ASHCRAFT
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3644 PEAVINE RD
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38571-7923
Mailing Address - Country:US
Mailing Address - Phone:931-709-0661
Mailing Address - Fax:931-709-0661
Practice Address - Street 1:6429 LEE HWY STE 101
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-4778
Practice Address - Country:US
Practice Address - Phone:423-622-0087
Practice Address - Fax:423-622-0087
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN772237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist