Individual
MS. LATISHA JOLENE FLORENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
281 US HIGHWAY 60 W, REPUBLIC, MO 65738-1432
(417) 200-2169
Mailing address
2325 E LUNAR ST, REPUBLIC, MO 65738-1759
(417) 200-2169
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2015043559
MO
101YM0800X
Mental Health Counselor
2015043559
MO
101YP2500X
Professional Counselor
Primary
2015043559
MO
Other
Enumeration date
01/11/2016
Last updated
10/15/2024
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