Individual
KATHLEEN MARIE LATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2423 GLENWOOD AVE, JOLIET, IL 60435-5483
(815) 725-9992
(815) 725-9993
Mailing address
1312 MEGAN CT, MINOOKA, IL 60447-9812
(815) 521-0958
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
KL84520906P
IL
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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