Provider Demographics
NPI:1780790220
Name:GUTHRIE, LATRECA DAWN (LMSW)
Entity type:Individual
Prefix:
First Name:LATRECA
Middle Name:DAWN
Last Name:GUTHRIE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:LATRECA
Other - Middle Name:DAWN
Other - Last Name:EYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12700 CHAPMAN DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79118-3617
Mailing Address - Country:US
Mailing Address - Phone:325-280-4443
Mailing Address - Fax:
Practice Address - Street 1:12700 CHAPMAN DR STE 1
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79118-3617
Practice Address - Country:US
Practice Address - Phone:325-280-4443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX248191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical