Provider Demographics
NPI:1326392838
Name:THORPE, LATONYA RENEE (LCAS)
Entity Type:Individual
Prefix:PROF
First Name:LATONYA
Middle Name:RENEE
Last Name:THORPE
Suffix:
Gender:F
Credentials:LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 N MAIN ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-3720
Mailing Address - Country:US
Mailing Address - Phone:704-618-2615
Mailing Address - Fax:
Practice Address - Street 1:1326 N MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-3720
Practice Address - Country:US
Practice Address - Phone:704-618-2615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-06
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3034-A174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist