Kristen Leigh Latra, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101002076 Issued in MI

Practice address

23983 Lyon Ridge Dr
South Lyon, MI 48178-8229

Phone

(586) 292-4592

NPI assigned

Aug 24, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503532800000",
    "number": "1255858858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23983 LYON RIDGE DR",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481788229",
            "telephone_number": "586-292-4592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23983 LYON RIDGE DR",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481788229",
            "telephone_number": "586-292-4592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATRA",
        "first_name": "KRISTEN",
        "middle_name": "LEIGH",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2017-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101002076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell John Lalonde, DC
• Monica Juliet Laming, LMSW
• Landi a Heller DDS
• Stephanie Langa, RD
• Marie Christine Larose, LMSW, CAADC
• Jeffrey Lau, D.O.
• Leah Towers Speech and Language, LLC
• Ryan Gaston Leckner
• Ellen Thomi Lecureux, PHYSICAL THERAPIST
• Michaela Rose Lee

• Speech-Language Pathologist in South Lyon, MI
• Providers in South Lyon, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.