MEDICARE: LATOYA S MINOR LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	59088	TX

General Provider Information

NPI Number	:	1164288668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATOYA S MINOR LCSW

Provider Business Mailing Address
First Line	:	759 CASPIAN WAY
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-2555
Country	:	US
Telephone Number	:	817-681-4438
Fax Number	:

Provider Business Practice Location Address
First Line	:	1720 OAK VILLAGE BLVD STE 200B
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-7952
Country	:	US
Telephone Number	:	817-681-4438
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2024
Last Update Date	:	03/10/2026

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Directions to “ LATOYA S MINOR LCSW” Practice Location

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