Individual
DR. LATASHA D GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
502 N CARROLL AVE STE 120, SOUTHLAKE, TX 76092-6449
(682) 292-7012
Mailing address
502 N CARROLL AVE STE 120, SOUTHLAKE, TX 76092-6449
(682) 292-7012
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
36918
TX
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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