Individual
DOMINIC CHRISTEPHER LATHOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1300 NW HARRISON BLVD, CORVALLIS, OR 97330-6277
(541) 203-0485
(541) 833-6656
Mailing address
1300 NW HARRISON BLVD, CORVALLIS, OR 97330-6277
(541) 203-0485
(541) 833-6656
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
03/02/2020
Last updated
08/12/2024
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