Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | I.1501349-SUPV | OH |
NPI | 1003002684 |
---|---|
Provider Name | Carrie C Latt |
First Address | Moraine, OH 45439-1983 |
Second Address | Moraine, OH 45439-1983 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2007 |
Last Update Date | 27/10/2021 |