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Individual

DR. TRACY THOMPSON LATZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D., M.S.

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
34660
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
41028
ABPN CERT. # EXP. 2014
01
51148
BCBS
NC
01
58366
MEDCOST
NC
05
7951148
NC
01
NC 34660
STATE LICENSE
NC
Enumeration date
07/26/2006
Last updated
03/07/2023
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