Provider Demographics
NPI:1437457355
Name:SAFE, LATOSHA BETH
Entity Type:Individual
Prefix:
First Name:LATOSHA
Middle Name:BETH
Last Name:SAFE
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 1:699 W BOGGY DEPOT RD
Mailing Address - Street 2:
Mailing Address - City:ATOKA
Mailing Address - State:OK
Mailing Address - Zip Code:74525-4531
Mailing Address - Country:US
Mailing Address - Phone:580-916-8480
Mailing Address - Fax:
Practice Address - Street 1:699 W BOGGY DEPOT RD
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:OK
Practice Address - Zip Code:74525-4531
Practice Address - Country:US
Practice Address - Phone:580-916-8480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor