Doctor Name: | DR. TRACEY E LATZA |
NPI Number: | 1760599211 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 3601-125 |
Business Practice Address: | 12760 W North Ave Building A Brookfield, WI - 530054628 |
Business Phone Number: | 2624395500 |
Business Fax Number: | 8664395221 |
Mailing Address: | 12760 W North Ave, Building A BROOKFIELD |
State: | WI |
Postal Code: | 530054628 |
Phone Number: | 2624395500 |
Fax Number: | 8664395221 |
NPI Enumeration Date: | 08/23/2006 |
NPI Last Update Date: | 02/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 3601-125 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |