Individual
ALICIA MARIE LATRAILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 N GRANT AVE, ODESSA, TX 79761-4503
(432) 256-4424
Mailing address
600 N GRANT AVE, ODESSA, TX 79761-4503
(432) 256-4424
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
93565
TX
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/01/2020
Last updated
03/03/2026
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