Provider Information for 1710141882
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LATASHA RENE RIVERS DSW, LISW-CP
Other Names:Former Name:LATASHA RENE HIGH SWSex: Female
NPI: 1710141882
Last Updated: 2023-09-07
Certification Date: 2023-09-07
Certification Date: 2023-09-07
Details
| Name | Value | ||||||||||||
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| NPI | 1710141882 | ||||||||||||
| Enumeration Date | 2008-07-17 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 250 GLENIS DR MURFREESBORO, TN 37129-5160 United States Phone: 615-225-5815 | Fax: | ||||||||||||
| Primary Practice Address | 3400 LEBANON RD MURFREESBORO, TN 37129-1392 United States Phone: 615-867-6000 | Fax: | ||||||||||||
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