Provider Demographics
NPI:1366807935
Name:EUGENE, LATANYA
Entity type:Individual
Prefix:
First Name:LATANYA
Middle Name:
Last Name:EUGENE
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 1:1 SUMMERTON DR
Mailing Address - Street 2:APT 48F
Mailing Address - City:SAINT ROSE
Mailing Address - State:LA
Mailing Address - Zip Code:70087-3459
Mailing Address - Country:US
Mailing Address - Phone:504-994-5957
Mailing Address - Fax:
Practice Address - Street 1:118 LAKEWOOD DR
Practice Address - Street 2:
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070-6114
Practice Address - Country:US
Practice Address - Phone:504-209-3256
Practice Address - Fax:504-943-1858
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-23
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor