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NPI Code Detail

MEDICARE: MS. ELIZABETH LESLIE LATHAM MFT

MEDICARE:  MS. ELIZABETH LESLIE LATHAM  MFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1538203039
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH LESLIE LATHAM MFT
Provider Business Mailing Address
First Line : 1201 ALTA VISTA RD
Second Line : APT 310
City : SANTA BARBARA
State : CA
Zip : 93103-2369
Country : US
Telephone Number : 805-962-9609
Fax Number :
Provider Business Practice Location Address
First Line : 25 W ANAPAMU ST
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93101-5148
Country : US
Telephone Number : 805-730-7575
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2007
Last Update Date : 07/08/2007

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