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Individual

MARK E LATTIMORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.DIV, LCASA

Contact information

Practice address
143 OLD WAGY RD, FOREST CITY, NC 28043-9466
(828) 447-2477
Mailing address
191 WALKALOOSA WAY, MOORESBORO, NC 28114-7830
(828) 447-2477

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-29161
NC

Other

Enumeration date
07/24/2023
Last updated
07/24/2023
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