Provider Demographics
NPI:1871915363
Name:MITCHELL, LATOYA
Entity type:Individual
Prefix:MS
First Name:LATOYA
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3027 WESTWOOD MANOR LANE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047
Mailing Address - Country:US
Mailing Address - Phone:337-251-1826
Mailing Address - Fax:281-974-2307
Practice Address - Street 1:3027 WESTWOOD MANOR LANE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047
Practice Address - Country:US
Practice Address - Phone:713-428-1995
Practice Address - Fax:281-974-2307
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-17
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105511235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist