Individual
STEPHANIE LATKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLPC
Contact information
Practice address
19855 OUTER DR STE 300W, DEARBORN, MI 48124-2189
(313) 359-1977
Mailing address
3920 PINE CREST CT, JACKSON, MI 49203-3200
(615) 484-1849
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/17/2020
Last updated
11/17/2020
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