Provider Demographics
NPI:1457565715
Name:LATORRE, DELIA JANICE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:DELIA
Middle Name:JANICE
Last Name:LATORRE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 W. PLYMOUTH STREET
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603
Mailing Address - Country:US
Mailing Address - Phone:813-245-2181
Mailing Address - Fax:
Practice Address - Street 1:3825 HENDERSON BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5037
Practice Address - Country:US
Practice Address - Phone:813-839-6700
Practice Address - Fax:813-835-1722
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 11509101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health