Provider Demographics
NPI:1306155791
Name:STERNOD, LATISHA
Entity type:Individual
Prefix:
First Name:LATISHA
Middle Name:
Last Name:STERNOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3206 50TH STREET CT STE 105D
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-8490
Mailing Address - Country:US
Mailing Address - Phone:253-649-2689
Mailing Address - Fax:253-442-6175
Practice Address - Street 1:3206 50TH STREET CT STE 105D
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-8490
Practice Address - Country:US
Practice Address - Phone:253-649-2689
Practice Address - Fax:253-442-6175
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-01
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health