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General NPI Number Information
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NPI Number | 1679385892
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Entity Type | Individual
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Provider Name | JAMES COREY LATTA P-LPC
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Gender | Male
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 199 SUMMITT ST
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City | MEMPHIS
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State | TN
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Zip | 38104-4238
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Country | US
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Telephone | 901-248-0595
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Fax |
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Provider Business Mailing Address
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Address Line | 3566 CRESTWYN DR
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City | GERMANTOWN
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State | TN
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Zip | 38138-8525
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Country | US
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Telephone | 901-371-7076
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | P-0711
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License Number State | MS
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