Healthcare Provider Details

I. General information

NPI: 1063359602
Provider Name (Legal Business Name): LATOYA HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 MARKET ST
BRIDGEVILLE DE
19933-1133
US

IV. Provider business mailing address

100 MARKET ST
BRIDGEVILLE DE
19933-1127
US

V. Phone/Fax

Practice location:
  • Phone: 302-337-8771
  • Fax:
Mailing address:
  • Phone: 302-258-6459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: