Provider Demographics
NPI:1851163687
Name:CHILDS, LATTIA
Entity Type:Individual
Prefix:MS
First Name:LATTIA
Middle Name:
Last Name:CHILDS
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 1:612 SUNNYSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:EAST PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15112-1140
Mailing Address - Country:US
Mailing Address - Phone:412-448-3100
Mailing Address - Fax:
Practice Address - Street 1:4400 OLD WILLIAM PENN HWY STE 100F
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-1480
Practice Address - Country:US
Practice Address - Phone:412-412-3386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2023-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA748236013747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant