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Organization
LATRECE GAITHER, LLC
Active
Organization
LATRECE GAITHER, LLC
Active
Other names
LaTrece Gaither, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
LATRECE GAITHER (OWNER/PROVIDER)
(971) 236-2728
Entity
Organization
Contact information
Practice address
510 NE ROBERTS AVE STE 200, GRESHAM, OR 97030-7484
(971) 236-2728
(855) 719-2524
Mailing address
PO BOX 214, FAIRVIEW, OR 97024-0214
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316295587
NPI
OR
Enumeration date
09/30/2022
Last updated
09/30/2022
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