Provider Demographics
NPI:1457106320
Name:BARNETT, LATARA (STNA ,CNA ,QMHS)
Entity Type:Individual
Prefix:
First Name:LATARA
Middle Name:
Last Name:BARNETT
Suffix:
Gender:F
Credentials:STNA ,CNA ,QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 JAVIT CT
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2439
Mailing Address - Country:US
Mailing Address - Phone:330-809-7544
Mailing Address - Fax:
Practice Address - Street 1:640 KENDIS CIR APT D
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-4752
Practice Address - Country:US
Practice Address - Phone:330-809-7544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator