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Individual

CARRI RENE LATTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LLPC

Contact information

Practice address
303 N CEDAR ST, KALKASKA, MI 49646-8424
(231) 258-6855
Mailing address
PO BOX 99, KALKASKA, MI 49646-0099
(231) 258-6855

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6401009271
MI
101YP2500X
Professional Counselor
Primary
6401223280
MI
104100000X
Social Worker
6802078495
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
COUN 09-99429
MICHIGAN DEPT OF HUMAN SERVICES
MI
Enumeration date
09/07/2011
Last updated
09/19/2023
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