Healthcare Provider Details

I. General information

NPI: 1952726093
Provider Name (Legal Business Name): LATOYA BROWN LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2014
Last Update Date: 06/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 COLLINGWOOD BLVD
TOLEDO OH
43610-1173
US

IV. Provider business mailing address

3350 COLLINGWOOD BLVD
TOLEDO OH
43610-1173
US

V. Phone/Fax

Practice location:
  • Phone: 419-255-9585
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1500136
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: