Provider Demographics
NPI:1356098685
Name:LATIN-KASPER, ALYSSA JOY (LPC-IT)
Entity type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:JOY
Last Name:LATIN-KASPER
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 W GLEN OAKS LN STE 109
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092-3372
Mailing Address - Country:US
Mailing Address - Phone:262-834-9013
Mailing Address - Fax:262-236-9805
Practice Address - Street 1:1025 W GLEN OAKS LN STE 109
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-3372
Practice Address - Country:US
Practice Address - Phone:262-834-9013
Practice Address - Fax:262-236-9805
Is Sole Proprietor?:No
Enumeration Date:2022-03-07
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5129-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional