Individual
MS. AUDRA ELISABETH LATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
10250 NORMANDY BLVD UNIT 802, JACKSONVILLE, FL 32221-8064
(904) 379-7155
(904) 379-7165
Mailing address
9536 PRINCETON SQUARE BLVD S APT 2507, JACKSONVILLE, FL 32256-8357
(904) 234-4660
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH8899
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013943700
—
FL
Enumeration date
12/04/2006
Last updated
07/21/2022
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