Provider Demographics
NPI:1730636671
Name:RAYMOND, LATANYA (MBA)
Entity Type:Individual
Prefix:
First Name:LATANYA
Middle Name:
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5559 NW BARRY RD
Mailing Address - Street 2:SUITE 345
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-1408
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5559 NW BARRY RD
Practice Address - Street 2:SUITE 345
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-1408
Practice Address - Country:US
Practice Address - Phone:314-619-0293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information
No172V00000XOther Service ProvidersCommunity Health Worker
No385H00000XRespite Care FacilityRespite Care