Individual
DR. ELIZABETH HOPE LATU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
8312 KASEMAN CT NE, ALBUQUERQUE, NM 87110-7639
(505) 291-5300
(505) 291-5301
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5361
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY21810
CA
103TC0700X
Clinical Psychologist
1386
NM
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1386
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26722224
—
NM
Enumeration date
03/27/2007
Last updated
03/03/2016
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