Provider Demographics
NPI:1164049284
Name:SLEW-NGARAMBE, LATOYA KIMBERLY
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:KIMBERLY
Last Name:SLEW-NGARAMBE
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 1:1910 SHERIDAN DR APT 10
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14223-1220
Mailing Address - Country:US
Mailing Address - Phone:917-975-3158
Mailing Address - Fax:
Practice Address - Street 1:262 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-1539
Practice Address - Country:US
Practice Address - Phone:716-954-3245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)