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General NPI Number Information
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NPI Number | 1811121866
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Entity Type | Individual
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Provider Name | MICHAEL L. LATIMER LMFT, CPCC
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Gender | Male
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Dates
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Enumeration Date | 05/06/2009
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Last Update Date | 05/06/2009
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Provider Practice Location Address
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Address Line | 801 S SPAULDING AVE
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City | LOS ANGELES
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State | CA
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Zip | 90036-4607
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Country | US
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Telephone | 310-923-4628
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Fax | 323-857-1718
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Provider Business Mailing Address
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Address Line | 803 S SPAULDING AVE
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City | LOS ANGELES
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State | CA
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Zip | 90036-4607
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Country | US
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Telephone | 310-923-4628
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Fax | 323-857-1718
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 45979
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License Number State | CA
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