Provider Demographics
NPI:1518520287
Name:HOWARD, LATOYA RENEE
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:RENEE
Last Name:HOWARD
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 1:4706 N 22ND ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-6335
Mailing Address - Country:US
Mailing Address - Phone:414-999-6603
Mailing Address - Fax:
Practice Address - Street 1:4706 N 22ND ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-6335
Practice Address - Country:US
Practice Address - Phone:414-999-6603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
WI0017326372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator