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NPI Code Detail

MEDICARE: LATOYIA DOUGLAS

MEDICARE: LATOYIA DOUGLAS
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1538400171
Entity Type Code : Individual
Provider Name (Legal Business Name) : LATOYIA DOUGLAS
Provider Business Mailing Address
First Line : 6461 ALTA DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-3301
Country : US
Telephone Number : 702-738-9629
Fax Number :
Provider Business Practice Location Address
First Line : 1200 HELEN AVE
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-3721
Country : US
Telephone Number : 702-275-9838
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2013
Last Update Date : 03/06/2013

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Directions to “ LATOYIA DOUGLAS ” Practice Location

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