| NPI | 1558865634 |
|---|---|
| Former Name | LATISHA CORRENN ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2023-06-06 |