Provider Demographics
NPI:1063531655
Name:LATTA, MARIA C (MS CCC SLP)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:C
Last Name:LATTA
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:C
Other - Last Name:DEPASQUALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC SLP
Mailing Address - Street 1:214 SAMOSET ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360
Mailing Address - Country:US
Mailing Address - Phone:508-746-6980
Mailing Address - Fax:508-862-7345
Practice Address - Street 1:27 PARK ST
Practice Address - Street 2:CAPE COD HOSPITAL REHABILITATION SERVICES INPATIENT REH
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601
Practice Address - Country:US
Practice Address - Phone:508-862-5756
Practice Address - Fax:508-862-7345
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2859235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist