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Individual

LATONYA NARCISSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2548 MEMORIAL BLVD, PORT ARTHUR, TX 77640-2825
(409) 983-1161
Mailing address
2548 MEMORIAL BLVD, PORT ARTHUR, TX 77640-2825

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12308
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
760289927
TAX ID
TX
Enumeration date
11/02/2017
Last updated
11/02/2017
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