Provider Demographics
NPI:1124172457
Name:LATTER, SHAYNE PAULINE (MSW)
Entity type:Individual
Prefix:MISS
First Name:SHAYNE
Middle Name:PAULINE
Last Name:LATTER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:228 HELIOS AVE
Mailing Address - Street 2:APT. C
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-3774
Mailing Address - Country:US
Mailing Address - Phone:504-832-9610
Mailing Address - Fax:504-349-8768
Practice Address - Street 1:5001 WESTBANK EXPY
Practice Address - Street 2:CHILDREN'S UNIT
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-2922
Practice Address - Country:US
Practice Address - Phone:504-349-8749
Practice Address - Fax:504-349-8768
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA93321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical