Individual
JACQUIE LATZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
21326 SUMMERBROOK DR, CORNELIUS, NC 28031-8543
(704) 451-9886
Mailing address
21326 SUMMERBROOK DR, CORNELIUS, NC 28031-8543
(704) 451-9886
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5015
NC
101YP2500X
Professional Counselor
5015
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6103454
—
NC
Enumeration date
09/06/2006
Last updated
09/11/2025
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