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:
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Health care specialties

SpecialtyCodeLicense #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 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982747630 NPPES
Oklahoma MEDICAID 200343820A
Oklahoma Other 452556312

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