Provider Demographics
NPI:1609434844
Name:SCOTT, LATOSHA (CASE MANAGER)
Entity Type:Individual
Prefix:
First Name:LATOSHA
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2658 CREEKWOOD CIR APT 12
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-3284
Mailing Address - Country:US
Mailing Address - Phone:937-999-4551
Mailing Address - Fax:937-999-4551
Practice Address - Street 1:1442 SWINGER DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-8225
Practice Address - Country:US
Practice Address - Phone:937-304-1140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator