Provider Demographics
NPI:1073902383
Name:MARION, LATOYA (MHA)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:
Last Name:MARION
Suffix:
Gender:F
Credentials:MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1132 KAIGHNS AVE
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-2712
Mailing Address - Country:US
Mailing Address - Phone:267-235-6578
Mailing Address - Fax:
Practice Address - Street 1:1132 KAIGHNS AVE
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-2712
Practice Address - Country:US
Practice Address - Phone:267-235-6578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-10
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372600000XNursing Service Related ProvidersAdult Companion