Provider Demographics
NPI:1790371680
Name:LATIOLAIS, ELIZABETH CHAUVIN (LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CHAUVIN
Last Name:LATIOLAIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 650859 DEPT 710
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-1120
Mailing Address - Country:US
Mailing Address - Phone:409-772-2222
Mailing Address - Fax:409-772-2663
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-1120
Practice Address - Country:US
Practice Address - Phone:409-772-2166
Practice Address - Fax:409-772-2663
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX364601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical