Provider Demographics
NPI:1396386652
Name:LATIN, OLAN JAMANE I (MA,LPC)
Entity type:Individual
Prefix:MR
First Name:OLAN
Middle Name:JAMANE
Last Name:LATIN
Suffix:I
Gender:M
Credentials:MA,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 W WALKER ST APT 7204
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-4293
Mailing Address - Country:US
Mailing Address - Phone:832-801-9614
Mailing Address - Fax:
Practice Address - Street 1:11303 CHIMNEY ROCK RD STE 400-A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-2901
Practice Address - Country:US
Practice Address - Phone:832-801-9614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-07
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72525101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional