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Individual

KIRA KRISTINA LATHROP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LPC, DBTC

Contact information

Practice address
621 W MADRONE ST, ROSEBURG, OR 97470-3090
(541) 440-3532
(541) 440-3554
Mailing address
PO BOX 1121, ROSEBURG, OR 97470-0254
(541) 440-3532
(541) 440-3554

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
151871
AK
101YP2500X
Professional Counselor
7315
SD
101YP2500X
Professional Counselor
Primary
C10435
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1712999
AK
Enumeration date
05/17/2016
Last updated
10/08/2025
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