Provider Demographics
NPI:1457305013
Name:LATINI, SUSAN C (LMHC)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:C
Last Name:LATINI
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 1:6808 NW 20TH PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-3224
Mailing Address - Country:US
Mailing Address - Phone:352-262-8715
Mailing Address - Fax:352-373-9585
Practice Address - Street 1:6808 NW 20TH PL
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-3224
Practice Address - Country:US
Practice Address - Phone:352-262-8715
Practice Address - Fax:352-373-9585
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2215174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist