Individual
KRISTEN LEIGH LATRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
23983 LYON RIDGE DR, SOUTH LYON, MI 48178-8229
(586) 292-4592
Mailing address
23983 LYON RIDGE DR, SOUTH LYON, MI 48178-8229
(586) 292-4592
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101002076
MI
Other
Enumeration date
08/24/2017
Last updated
08/24/2017
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