Provider Demographics
NPI:1346566510
Name:WOLFORD, LATOYA MICHELLE
Entity Type:Individual
Prefix:MRS
First Name:LATOYA
Middle Name:MICHELLE
Last Name:WOLFORD
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 1:33448 VINE ST
Mailing Address - Street 2:APT 201B
Mailing Address - City:WILLOWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44095-3444
Mailing Address - Country:US
Mailing Address - Phone:216-789-9527
Mailing Address - Fax:440-942-6940
Practice Address - Street 1:33448 VINE ST
Practice Address - Street 2:APT 201B
Practice Address - City:WILLOWICK
Practice Address - State:OH
Practice Address - Zip Code:44095-3444
Practice Address - Country:US
Practice Address - Phone:216-789-9527
Practice Address - Fax:440-942-6940
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN346933163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse