Provider Demographics
NPI:1366026098
Name:DINSMORE, LATOSHA LEANN
Entity Type:Individual
Prefix:
First Name:LATOSHA
Middle Name:LEANN
Last Name:DINSMORE
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 1:2202 PEACEABLE RD
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-9103
Mailing Address - Country:US
Mailing Address - Phone:918-429-7950
Mailing Address - Fax:918-429-7958
Practice Address - Street 1:2202 PEACEABLE RD
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-9103
Practice Address - Country:US
Practice Address - Phone:918-429-7950
Practice Address - Fax:918-429-7958
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator