Provider Demographics
NPI:1235475781
Name:PROCTOR, LATOYA (LATOYA PROCTOR)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:
Last Name:PROCTOR
Suffix:
Gender:F
Credentials:LATOYA PROCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 E TROPICANA AVE STE 137
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6552
Mailing Address - Country:US
Mailing Address - Phone:702-460-0690
Mailing Address - Fax:
Practice Address - Street 1:1516 E TROPICANA AVE STE 137
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6552
Practice Address - Country:US
Practice Address - Phone:702-530-2788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst