Provider Demographics
NPI:1497105878
Name:PARHAM, LATARSHA
Entity Type:Individual
Prefix:
First Name:LATARSHA
Middle Name:
Last Name:PARHAM
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 1:2384 FREEDOM BLVD
Mailing Address - Street 2:B3
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-6177
Mailing Address - Country:US
Mailing Address - Phone:843-230-4259
Mailing Address - Fax:
Practice Address - Street 1:2384 FREEDOM BLVD
Practice Address - Street 2:B3
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-6177
Practice Address - Country:US
Practice Address - Phone:843-230-4259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator