Provider Demographics
NPI:1982814331
Name:LATINO, KLAIR ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:KLAIR
Middle Name:ELIZABETH
Last Name:LATINO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77009-8525
Mailing Address - Country:US
Mailing Address - Phone:713-206-5743
Mailing Address - Fax:713-236-7122
Practice Address - Street 1:1615 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009-8525
Practice Address - Country:US
Practice Address - Phone:713-203-4980
Practice Address - Fax:713-236-7122
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS411701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX035843OtherHARRIS COUNTY PROVIDER
TX8L8432Medicare PIN