MEDICARE: LATOSHA STOKER

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	104100000X	Social Worker	S.2309525	OH

General Provider Information

NPI Number	:	1215628722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATOSHA STOKER

Provider Business Mailing Address
First Line	:	4579 EVERHARD RD NW STE A
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44718-2425
Country	:	US
Telephone Number	:	330-227-6768
Fax Number	:

Provider Business Practice Location Address
First Line	:	4579 EVERHARD RD NW STE A
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44718-2425
Country	:	US
Telephone Number	:	330-305-1668
Fax Number	:	330-305-1696

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

Provider Enumeration Date	:	05/16/2023
Last Update Date	:	03/18/2024

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Directions to “ LATOSHA STOKER ” Practice Location

Language	Start Address	Practice Location

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