Healthcare Provider Details

I. General information

NPI: 1740113596
Provider Name (Legal Business Name): LATOYA N SIMON PCT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3419 NW EVANGELINE TRWY STE E14
CARENCRO LA
70520-6241
US

IV. Provider business mailing address

3419 NW EVANGELINE TRWY STE E14
CARENCRO LA
70520-6241
US

V. Phone/Fax

Practice location:
  • Phone: 337-806-7696
  • Fax:
Mailing address:
  • Phone: 337-806-7696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Q00000X
TaxonomyPathology Specialist/Technologist
License Number351772
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: