Healthcare Provider Details

I. General information

NPI: 1851985857
Provider Name (Legal Business Name): LATOYA HARDING LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2021
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3308 PRIVATEWOOD RD
PINE BLUFF AR
71603-6519
US

IV. Provider business mailing address

109 FRANKIE LN
WHITE HALL AR
71602-2685
US

V. Phone/Fax

Practice location:
  • Phone: 870-692-8308
  • Fax:
Mailing address:
  • Phone: 870-247-3588
  • Fax: 870-247-2072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP2106021
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: