Provider Demographics
NPI:1093476335
Name:HARRIS, LATONYA MONIQUE (LMFT, LAC, FULL SOMB)
Entity Type:Individual
Prefix:MRS
First Name:LATONYA
Middle Name:MONIQUE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LMFT, LAC, FULL SOMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5664
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80931-5664
Mailing Address - Country:US
Mailing Address - Phone:720-275-1407
Mailing Address - Fax:
Practice Address - Street 1:7430 E CALEY AVE STE 125
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-6913
Practice Address - Country:US
Practice Address - Phone:720-275-1407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-08
Last Update Date:2022-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO.0001467106H00000X
COMFT.0001467106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist