Provider Demographics
NPI:1952824245
Name:LAFFITTE, LATONIA
Entity Type:Individual
Prefix:
First Name:LATONIA
Middle Name:
Last Name:LAFFITTE
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 1:4609 PENZANCE PL
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-6923
Mailing Address - Country:US
Mailing Address - Phone:301-485-5259
Mailing Address - Fax:866-473-0699
Practice Address - Street 1:7050 CHESAPEAKE RD STE 104
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-2345
Practice Address - Country:US
Practice Address - Phone:301-485-5259
Practice Address - Fax:866-473-0699
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-19
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPR14938101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCPRC14938OtherLPC