Individual
LATRIZ MIMIKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13302 10TH ST, BOWIE, MD 20715-3703
(202) 378-0172
Mailing address
13302 10TH ST, BOWIE, MD 20715-3703
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
32840
MD
Other
Enumeration date
09/19/2025
Last updated
10/24/2025
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