| Doctor Name: | CICERO LATIMORE |
| NPI Number: | 1023296662 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | 002912 |
| Business Practice Address: | 940 Ga Highway 96 Warner Robins, GA - 310882584 |
| Business Phone Number: | 4789881222 |
| Business Fax Number: | 4789881106 |
| Mailing Address: | 940 Highway 96, WARNER ROBINS |
| State: | GA |
| Postal Code: | 31093 |
| Phone Number: | 4789881222 |
| Fax Number: | 4789881106 |
| NPI Enumeration Date: | 02/06/2008 |
| NPI Last Update Date: | 02/06/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 002912 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |