Provider Demographics
NPI:1265142905
Name:PALMER, LATASHIA JOANN (MS)
Entity type:Individual
Prefix:
First Name:LATASHIA
Middle Name:JOANN
Last Name:PALMER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 WELMONT ST
Mailing Address - Street 2:
Mailing Address - City:WELDON
Mailing Address - State:NC
Mailing Address - Zip Code:27890-2031
Mailing Address - Country:US
Mailing Address - Phone:571-439-0127
Mailing Address - Fax:
Practice Address - Street 1:1407 WELMONT ST
Practice Address - Street 2:
Practice Address - City:WELDON
Practice Address - State:NC
Practice Address - Zip Code:27890-2031
Practice Address - Country:US
Practice Address - Phone:571-439-0127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor