Provider Demographics
NPI:1780140418
Name:DONALDSON, LATSAHA CAPRI
Entity type:Individual
Prefix:
First Name:LATSAHA
Middle Name:CAPRI
Last Name:DONALDSON
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 1:6 INDUSTRIAL WAY E STE D
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3317
Mailing Address - Country:US
Mailing Address - Phone:732-982-3007
Mailing Address - Fax:732-389-2121
Practice Address - Street 1:6 INDUSTRIAL WAY E STE D
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-3317
Practice Address - Country:US
Practice Address - Phone:732-982-3007
Practice Address - Fax:732-389-2121
Is Sole Proprietor?:No
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator