Provider Demographics
NPI:1477618726
Name:TWEEDY, LATONIA RENEE (LPE-I)
Entity Type:Individual
Prefix:MRS
First Name:LATONIA
Middle Name:RENEE
Last Name:TWEEDY
Suffix:
Gender:F
Credentials:LPE-I
Other - Prefix:
Other - First Name:LATONIA
Other - Middle Name:
Other - Last Name:CROSS-TWEEDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10025 WEST MARKHAM ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205
Mailing Address - Country:US
Mailing Address - Phone:501-663-5473
Mailing Address - Fax:501-801-1816
Practice Address - Street 1:10025 WEST MARKHAM ST
Practice Address - Street 2:SUITE 210
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-663-5473
Practice Address - Fax:501-801-1816
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR00-6E101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health