Provider Demographics
NPI:1356173488
Name:MCDOWELL, LATTOY FLAVIAN
Entity type:Individual
Prefix:MRS
First Name:LATTOY
Middle Name:FLAVIAN
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:LATTOY
Other - Middle Name:FLAVIAN
Other - Last Name:GOLDBOURNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:166 WESTMINSTER ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01109-3895
Mailing Address - Country:US
Mailing Address - Phone:718-915-0509
Mailing Address - Fax:
Practice Address - Street 1:271 CAREW ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2377
Practice Address - Country:US
Practice Address - Phone:718-915-0509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health