Individual
LATISHIA CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 RADIO DR, WOODBURY, MN 55125-8409
(651) 454-0114
Mailing address
13570 GROVE DR N # 304, MAPLE GROVE, MN 55311-4400
(651) 398-6427
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC05060
MN
Other
Enumeration date
09/09/2025
Last updated
03/30/2026
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