Provider Demographics
NPI:1679120349
Name:LATUS, KILA MICHELE (MS ED, CCC-SLP TS)
Entity type:Individual
Prefix:
First Name:KILA
Middle Name:MICHELE
Last Name:LATUS
Suffix:
Gender:F
Credentials:MS ED, CCC-SLP TS
Other - Prefix:
Other - First Name:KILA
Other - Middle Name:MICHELE
Other - Last Name:GILCART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4635 UNION ROAD
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225
Mailing Address - Country:US
Mailing Address - Phone:716-505-5700
Mailing Address - Fax:
Practice Address - Street 1:161 KLEVIN STREET #103
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-561-8060
Practice Address - Fax:907-563-3172
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK149112235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist