Provider Demographics
NPI:1750756565
Name:WEBB, LARITA (PHD, MPH)
Entity type:Individual
Prefix:
First Name:LARITA
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:PHD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1242 N LIONS GATE DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38116-7818
Mailing Address - Country:US
Mailing Address - Phone:901-496-7132
Mailing Address - Fax:
Practice Address - Street 1:1242 N LIONS GATE DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-7818
Practice Address - Country:US
Practice Address - Phone:901-496-7132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-04
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator