Provider Demographics
NPI:1174832679
Name:LATELA, LOUISA (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:LOUISA
Middle Name:
Last Name:LATELA
Suffix:
Gender:F
Credentials:MSW, LCSW
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 304
Mailing Address - Street 2:
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-0304
Mailing Address - Country:US
Mailing Address - Phone:856-429-9799
Mailing Address - Fax:
Practice Address - Street 1:132 KINGS HWY E STE 105
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-2008
Practice Address - Country:US
Practice Address - Phone:856-429-9799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC045346001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical