Provider Demographics
NPI:1467639294
Name:CARTER, LATONYA (MED, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LATONYA
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102 ROGERS ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75670-6539
Mailing Address - Country:US
Mailing Address - Phone:903-452-0314
Mailing Address - Fax:
Practice Address - Street 1:2102 ROGERS ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75670-6539
Practice Address - Country:US
Practice Address - Phone:903-452-0314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-23
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6953235Z00000X
TX101872235Z00000X
AR202451235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist