| Doctor Name: | LATAVIA WYNEE CONNER |
| NPI Number: | 1073960985 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A. |
| License Number: | |
| Business Practice Address: | 6740 Foxbend Ct Florissant, MO - 630334807 |
| Business Phone Number: | 3142236944 |
| Business Fax Number: | |
| Mailing Address: | 6740 Foxbend Ct, FLORISSANT |
| State: | MO |
| Postal Code: | 630334807 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/20/2016 |
| NPI Last Update Date: | 05/20/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |