Provider Demographics
NPI:1093818361
Name:LATIMER, JEANNIE WALSH (LMHC)
Entity Type:Individual
Prefix:MS
First Name:JEANNIE
Middle Name:WALSH
Last Name:LATIMER
Suffix:
Gender:F
Credentials:LMHC
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 117500
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32611-7500
Mailing Address - Country:US
Mailing Address - Phone:352-392-1171
Mailing Address - Fax:352-846-1030
Practice Address - Street 1:1 FLETCHER DRIVE
Practice Address - Street 2:UNIVERSITY OF FLORIDA
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32611-7500
Practice Address - Country:US
Practice Address - Phone:352-392-1171
Practice Address - Fax:352-846-1030
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2214101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health