Provider Demographics
NPI:1922410661
Name:EDWARDS, LATOYA YVETTE (MPH, RD, CSP, LD)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:YVETTE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MPH, RD, CSP, LD
Other - Prefix:
Other - First Name:LATOYA
Other - Middle Name:YVETTE
Other - Last Name:EDWARDS-KING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPH, RD, CSP, LD
Mailing Address - Street 1:2222 WELBORN ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-3924
Mailing Address - Country:US
Mailing Address - Phone:214-559-5000
Mailing Address - Fax:214-443-7309
Practice Address - Street 1:2222 WELBORN ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-3924
Practice Address - Country:US
Practice Address - Phone:214-559-5000
Practice Address - Fax:214-443-7309
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT82020133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered