Provider Demographics
NPI:1356701619
Name:SAINTJUSTE, LETOSHA DENAE (CERT HAIR LOSS SPEC)
Entity type:Individual
Prefix:MRS
First Name:LETOSHA
Middle Name:DENAE
Last Name:SAINTJUSTE
Suffix:
Gender:F
Credentials:CERT HAIR LOSS SPEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 ROSSENDALE DR
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-7558
Mailing Address - Country:US
Mailing Address - Phone:254-466-9458
Mailing Address - Fax:
Practice Address - Street 1:412 ROSSENDALE DR
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-7558
Practice Address - Country:US
Practice Address - Phone:254-466-9458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC908271744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management