Provider Demographics
NPI:1083232094
Name:LATTA, FEDERICA
Entity Type:Individual
Prefix:
First Name:FEDERICA
Middle Name:
Last Name:LATTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VIALE DEI QUATTRO VENTI 128
Mailing Address - Street 2:
Mailing Address - City:ROMA
Mailing Address - State:RM
Mailing Address - Zip Code:00152
Mailing Address - Country:IT
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:VIALE DI VILLA PAMPHILI 64A
Practice Address - Street 2:
Practice Address - City:ROMA
Practice Address - State:RM
Practice Address - Zip Code:00152
Practice Address - Country:IT
Practice Address - Phone:334-720-3816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9628103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical