Provider Demographics
NPI:1477576056
Name:BROWN, LATONYA LAFAYE (BSPT)
Entity Type:Individual
Prefix:MRS
First Name:LATONYA
Middle Name:LAFAYE
Last Name:BROWN
Suffix:
Gender:F
Credentials:BSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9977 CROSSWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-5013
Mailing Address - Country:US
Mailing Address - Phone:318-671-9306
Mailing Address - Fax:
Practice Address - Street 1:9977 CROSSWOOD CIR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-5013
Practice Address - Country:US
Practice Address - Phone:318-671-9306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA03672225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist