Provider Demographics
NPI:1740892835
Name:MCLAURINE, LATONIA P
Entity type:Individual
Prefix:
First Name:LATONIA
Middle Name:P
Last Name:MCLAURINE
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 1:3008 GWYNNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-2722
Mailing Address - Country:US
Mailing Address - Phone:615-727-2065
Mailing Address - Fax:
Practice Address - Street 1:100 COUNTRY CLUB DR STE 200
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-4376
Practice Address - Country:US
Practice Address - Phone:615-348-5806
Practice Address - Fax:615-285-8130
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health