Provider Demographics
NPI:1689179152
Name:LLOYD, LATANYA PATRICE
Entity Type:Individual
Prefix:MS
First Name:LATANYA
Middle Name:PATRICE
Last Name:LLOYD
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 1:19211 ANGLIN ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48234-1460
Mailing Address - Country:US
Mailing Address - Phone:313-263-0077
Mailing Address - Fax:313-305-5007
Practice Address - Street 1:19211 ANGLIN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234-1460
Practice Address - Country:US
Practice Address - Phone:313-263-0077
Practice Address - Fax:313-305-5007
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool