Provider Demographics
NPI:1497480289
Name:LATULAS, BRIANNA MICHELLE
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MICHELLE
Last Name:LATULAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2808 HILLVIEW LN
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-2776
Mailing Address - Country:US
Mailing Address - Phone:210-202-8294
Mailing Address - Fax:
Practice Address - Street 1:2808 HILLVIEW LN
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-2776
Practice Address - Country:US
Practice Address - Phone:210-202-8294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician