| NPI | 1144604323 |
|---|---|
| Former Name | TINA MARIE LATTEYER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2015024667) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 77224) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD AC002532) | |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2025-07-25 |