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General NPI Number Information
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NPI Number | 1033962535
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Entity Type | Individual
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Provider Name | LATOYA JENKINS
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Gender | Female
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Dates
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Enumeration Date | 04/08/2024
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Last Update Date | 04/08/2024
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Provider Practice Location Address
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Address Line | 1601 ROBERT BRADBY DR APT 711
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City | DETROIT
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State | MI
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Zip | 48207-3857
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Country | US
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Telephone | 313-918-8265
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Fax |
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Provider Business Mailing Address
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Address Line | 20428 WOODLAND ST
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City | HARPER WOODS
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State | MI
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Zip | 48225-2054
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Country | US
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Telephone | 313-879-9736
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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