Individual
DR. PATRICK A. LATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 363-9988
Mailing address
177 METROPOLITAN AVE, ROSLINDALE, MA 02131-4228
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7919
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W06172
BLUE CROSS BLUE SHIELD ID
MA
Enumeration date
12/29/2006
Last updated
07/08/2007
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