Individual
LATRICE LYNETTE PRINCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11004 W LANGLADE ST, MILWAUKEE, WI 53225-1321
(414) 243-9544
Mailing address
11004 W LANGLADE ST, MILWAUKEE, WI 53225-1321
(414) 243-9544
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18422-130
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18422-130
—
WI
Enumeration date
12/04/2017
Last updated
06/16/2018
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