Provider Demographics
NPI:1710755194
Name:SMITH, LATOYA SMITH
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:SMITH
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LATOYA
Other - Middle Name:
Other - Last Name:SIGMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7373 BROOKCREST DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-3446
Mailing Address - Country:US
Mailing Address - Phone:513-802-5642
Mailing Address - Fax:
Practice Address - Street 1:7373 BROOKCREST DR STE 354
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-3448
Practice Address - Country:US
Practice Address - Phone:513-802-5642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-15
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator