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Individual

MS. ALICIA CAMILLE LATTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S

Contact information

Practice address
2920 S 25TH ST, FORT PIERCE, FL 34981-5605
(772) 766-4747
(772) 323-2404
Mailing address
223 MANLY AVE, SEBASTIAN, FL 32958-4603
(772) 766-4747

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
FL

Other

Enumeration date
01/21/2012
Last updated
01/21/2012
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