Individual
MR. NATHAN LATTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPRC
Contact information
Practice address
2081 W GRAND BLVD, DETROIT, MI 48208-1105
(313) 895-0500
Mailing address
707 W MILWAUKEE ST, DETROIT, MI 48202-2943
(313) 344-9099
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
M-00262
MI
175T00000X
Peer Specialist
Primary
—
MI
Other
Enumeration date
05/29/2019
Last updated
06/15/2023
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