Burnett, Latasha Renee
Burnett, Latasha Renee is an sole proprietor health care provider with primary practice located at 1201 Nw Arlington Ave Suite#E, Lawton OK 73507-6570. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Marriage & Family Therapist is her primary health care specialty. Burnett, Latasha Renee can be contacted via phone (580) 699-8680.Contact Information
Primary practice address
1201 Nw Arlington Ave Suite#E
Lawton OK 73507-6570
Phone: (580) 699-8680
Fax: (580) 699-8681
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | 938 | Oklahoma |
Behavioral Health & Social Service Providers / Mental Health | 101YM0800X |
Profile Details
NPI number | 1982747630 |
---|---|
LBN Legal business name | Burnett, Latasha Renee |
Credentials | M.S, LMFT |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Feb 14th, 2007 |
Last updated | Oct 20th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1982747630 | NPPES |
Oklahoma | MEDICAID | 200343820A | |
Oklahoma | Other | 452556312 |
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