Provider Demographics
NPI:1639518129
Name:YAITES, LATOYA D (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:LATOYA
Middle Name:D
Last Name:YAITES
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 BRAZOS BLVD APT 16306
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76039-5487
Mailing Address - Country:US
Mailing Address - Phone:512-423-6521
Mailing Address - Fax:
Practice Address - Street 1:1500 CORPORATE CIR STE 4
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-5954
Practice Address - Country:US
Practice Address - Phone:512-423-6521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68605101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional