MEDICARE: LATOSHA CECIL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency		OH

General Provider Information

NPI Number	:	1124984935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATOSHA CECIL

Provider Business Mailing Address
First Line	:	5393 EASTGATE DR APT 10
Second Line	:
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-3456
Country	:	US
Telephone Number	:	502-641-9301
Fax Number	:

Provider Business Practice Location Address
First Line	:	5393 EASTGATE DR APT 10
Second Line	:
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-3456
Country	:	US
Telephone Number	:	502-641-9301
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/25/2025
Last Update Date	:	12/25/2025

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Directions to “ LATOSHA CECIL ” Practice Location

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