MEDICARE: EMILEE LATKOVIC LMFT

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
1	106H00000X	Marriage & Family Therapist	F.2300341	OH

General Provider Information

NPI Number	:	1700491693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILEE LATKOVIC LMFT

Provider Business Mailing Address
First Line	:	PO BOX 748465
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-8465
Country	:	US
Telephone Number	:	855-284-7483
Fax Number	:	617-807-0958

Provider Business Practice Location Address
First Line	:	1890 NORTHWEST BLVD STE 140
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43212-1637
Country	:	US
Telephone Number	:	614-739-8926
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2020
Last Update Date	:	12/08/2025

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Directions to “ EMILEE LATKOVIC LMFT” Practice Location

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