Latham, Fonda Gail

Latham, Fonda Gail is an sole proprietor health care provider with primary practice located at 1305 S Baxter Ave , Tyler TX 75701-3404. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Latham, Fonda Gail can be contacted via phone (903) 714-1130.

Contact Information

Primary practice address
1305 S Baxter Ave Tyler TX 75701-3404
Phone: (903) 714-1130
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 00557 Texas

Profile Details

NPI number 1306978135
LBN Legal business name Latham, Fonda Gail
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 9th, 2007
Last updated Jul 8th, 2007 - about 17 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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