Provider Demographics
NPI:1497231500
Name:HENDRIX, LATOYA ROSHELLE (MASTERS OF EDUCATION)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:ROSHELLE
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:MASTERS OF EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111A HAWN AVENUE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71107-6643
Mailing Address - Country:US
Mailing Address - Phone:318-621-0910
Mailing Address - Fax:318-621-0918
Practice Address - Street 1:1111A HAWN AVENUE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71107-6643
Practice Address - Country:US
Practice Address - Phone:318-621-0910
Practice Address - Fax:318-621-0918
Is Sole Proprietor?:No
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator