MEDICARE: LATONYA DENISE HOWARD LMSW

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	6801081515	MI

General Provider Information

NPI Number	:	1609891100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATONYA DENISE HOWARD LMSW

Provider Business Mailing Address
First Line	:	28000 DEQUINDRE RD
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48092-2468
Country	:	US
Telephone Number	:	586-753-0405
Fax Number	:	586-753-0404

Provider Business Practice Location Address
First Line	:	20651 W WARREN ST
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-2622
Country	:	US
Telephone Number	:	313-271-3050
Fax Number	:

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	07/08/2007

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