| NPI | 1487060604 |
|---|---|
| Former Name | LATISHA ERICKA TAYLOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC010353) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA LPC010353) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2018-07-31 |