Individual
DR. LATISHA LYNN BADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2307 S GORDON COOPER DR, SHAWNEE, OK 74801-9007
(405) 273-5236
(405) 273-4345
Mailing address
2307 S GORDON COOPER DR, SHAWNEE, OK 74801-9007
(405) 273-5236
(405) 273-4345
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
1085
OK
Other
Enumeration date
08/05/2010
Last updated
08/05/2010
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