Provider Demographics
NPI:1184872871
Name:MCMURRAY, LATISHA MICHELLE
Entity type:Individual
Prefix:
First Name:LATISHA
Middle Name:MICHELLE
Last Name:MCMURRAY
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 1:1805 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:TX
Mailing Address - Zip Code:75428-3350
Mailing Address - Country:US
Mailing Address - Phone:903-268-4095
Mailing Address - Fax:
Practice Address - Street 1:1805 WALNUT ST
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:TX
Practice Address - Zip Code:75428-3350
Practice Address - Country:US
Practice Address - Phone:903-268-4095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor