Provider Demographics
NPI:1740752625
Name:HARPER, LATASHA (MS)
Entity Type:Individual
Prefix:
First Name:LATASHA
Middle Name:
Last Name:HARPER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 N ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-6612
Mailing Address - Country:US
Mailing Address - Phone:561-320-1777
Mailing Address - Fax:
Practice Address - Street 1:512 N ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401
Practice Address - Country:US
Practice Address - Phone:561-320-1777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No1744R1102XOther Service ProvidersSpecialistResearch StudyGroup - Multi-Specialty
No224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist