Individual
ANDREA LATELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25 OFFICE PARK DR, SUITE 2, KILMARNOCK, VA 22482-0188
(804) 435-7355
(804) 435-6836
Mailing address
PO BOX 188, KILMARNOCK, VA 22482-0188
(804) 435-7355
(804) 435-6836
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701003606
VA
Other
Enumeration date
08/16/2006
Last updated
07/08/2007
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