Provider Demographics
NPI:1831828169
Name:ALLEN, LATASHA LAVETTE (PHD)
Entity type:Individual
Prefix:DR
First Name:LATASHA
Middle Name:LAVETTE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2339 COMMERCE ST STE 135
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-2319
Mailing Address - Country:US
Mailing Address - Phone:432-698-0141
Mailing Address - Fax:281-605-6722
Practice Address - Street 1:2339 COMMERCE ST STE 135
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-2319
Practice Address - Country:US
Practice Address - Phone:432-698-0141
Practice Address - Fax:281-605-6722
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39218103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical