Provider Demographics
NPI:1982874392
Name:LATHAM, DEBBIE (RD, CDE, CPT)
Entity Type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:
Last Name:LATHAM
Suffix:
Gender:F
Credentials:RD, CDE, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75482-4132
Mailing Address - Country:US
Mailing Address - Phone:903-440-5184
Mailing Address - Fax:903-440-5184
Practice Address - Street 1:500 OAK AVE
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-4132
Practice Address - Country:US
Practice Address - Phone:903-440-5184
Practice Address - Fax:903-440-5184
Is Sole Proprietor?:No
Enumeration Date:2008-03-03
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT80499133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic