Provider Demographics
NPI:1235910720
Name:LATTIER, ALEXANDRA FINN (MA, SSP, LPES)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:FINN
Last Name:LATTIER
Suffix:
Gender:F
Credentials:MA, SSP, LPES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1646 HIGHWAY 160 W STE 105
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-8010
Mailing Address - Country:US
Mailing Address - Phone:803-881-9361
Mailing Address - Fax:
Practice Address - Street 1:530 SEVENTH AVENUE
Practice Address - Street 2:SUITE M1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018
Practice Address - Country:US
Practice Address - Phone:803-881-9361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4760103TS0200X
SC290427551252103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool