Wilson, Latisha Denise

Wilson, Latisha Denise is an sole proprietor health care provider with primary practice located at 507 N 8Th St , Killeen TX 76541-4867. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Wilson, Latisha Denise can be contacted via phone (254) 523-6710.

Contact Information

Primary practice address
507 N 8Th St Killeen TX 76541-4867
Phone: (254) 523-6710
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 33788 Texas
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 79124 Texas

Profile Details

NPI number 1447745716
LBN Legal business name Wilson, Latisha Denise
Credentials LPC, LMFT-A, LCDC-I
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 28th, 2018
Last updated Dec 11th, 2019 - about 7 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1447745716 NPPES
Texas MEDICAID 403747501

Popular Providers