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General NPI Number Information
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NPI Number | 1194497594
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Entity Type | Individual
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Provider Name | LATOYA COBB
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Gender | Female
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Dates
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Enumeration Date | 10/04/2021
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Last Update Date | 10/04/2021
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Provider Practice Location Address
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Address Line | 308 UNIONVILLE INDIAN TRAIL RD W STE C
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City | INDIAN TRAIL
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State | NC
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Zip | 28079-5551
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Country | US
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Telephone | 214-437-2272
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Fax |
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Provider Business Mailing Address
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Address Line | 1777 HARVARD AVE
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City | COLLEGE PARK
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State | GA
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Zip | 30337-2701
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Country | US
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Telephone | 929-232-4091
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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