Individual
RANDY LATTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., BCBA
Contact information
Practice address
45 US-11, SHAMOKIN DAM, PA 17876
(888) 726-4774
Mailing address
9 BANKS AVE, MCADOO, PA 18237-2508
(570) 590-1557
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-09-5277
—
103K00000X
Behavior Analyst
Primary
1095277
PA
Other
Enumeration date
02/13/2012
Last updated
06/02/2021
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