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Individual
MARY LATOCHE
Active
Individual
MARY LATOCHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP.10035
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000603852
ANTHEM BLUE CROSS AND BLUE SHIELD
OH
05
—
0113587
—
OH
01
—
12763285
CAQH
OH
Enumeration date
08/28/2014
Last updated
11/07/2019
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