| Doctor Name: | LATIAYA LANEE GROOMS |
| NPI Number: | 1013218999 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BA |
| License Number: | |
| Business Practice Address: | 31 Heath St Jamaica Plain, MA - 021301650 |
| Business Phone Number: | 6175236400 |
| Business Fax Number: | 6175233034 |
| Mailing Address: | 31 Heath St, JAMAICA PLAIN |
| State: | MA |
| Postal Code: | 021301650 |
| Phone Number: | 6175236400 |
| Fax Number: | 6175233034 |
| NPI Enumeration Date: | 11/09/2010 |
| NPI Last Update Date: | 08/23/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |