Provider Demographics
NPI:1124371471
Name:CLANTON, LATOYA MARIE
Entity Type:Individual
Prefix:MRS
First Name:LATOYA
Middle Name:MARIE
Last Name:CLANTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LATOYA
Other - Middle Name:MARIE
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1446 LOUISIANA LAKES AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-6934
Mailing Address - Country:US
Mailing Address - Phone:707-853-3442
Mailing Address - Fax:
Practice Address - Street 1:1446 LOUISIANA LAKES AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89183-6934
Practice Address - Country:US
Practice Address - Phone:707-853-3442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor