Provider Demographics
NPI:1114341245
Name:NEAL, LATONYA (DD RESIDENTIAL)
Entity Type:Individual
Prefix:MRS
First Name:LATONYA
Middle Name:
Last Name:NEAL
Suffix:
Gender:F
Credentials:DD RESIDENTIAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 PETUNIA DR
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:AL
Mailing Address - Zip Code:36301-6135
Mailing Address - Country:US
Mailing Address - Phone:334-718-5437
Mailing Address - Fax:
Practice Address - Street 1:1230 2ND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904
Practice Address - Country:US
Practice Address - Phone:706-321-9606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker