Basic Information
| Provider Information | |||||||||
| NPI: | 1124172457 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LATTER | ||||||||
| FirstName: | SHAYNE | ||||||||
| MiddleName: | PAULINE | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 228 HELIOS AVE | ||||||||
| Address2: | APT. C | ||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700053774 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048329610 | ||||||||
| FaxNumber: | 5043498768 | ||||||||
| Practice Location | |||||||||
| Address1: | 5001 WESTBANK EXPY | ||||||||
| Address2: | CHILDREN'S UNIT | ||||||||
| City: | MARRERO | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700722922 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5043498749 | ||||||||
| FaxNumber: | 5043498768 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 9332 | LA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.