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Individual

MR. JEFFREY LAWRENCE LATA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
1250 EXECUTIVE PL, BUILDING 500, GENEVA, IL 60134-3807
(630) 232-7457
Mailing address
627 OAKWOOD DR, GENEVA, IL 60134-1527
(630) 845-8847

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
IL

Other

Enumeration date
12/06/2006
Last updated
07/08/2007
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