Provider Demographics
NPI:1669951422
Name:GREENWOOD GILES, LATARSHA TALAINE (MED)
Entity type:Individual
Prefix:MRS
First Name:LATARSHA
Middle Name:TALAINE
Last Name:GREENWOOD GILES
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3419 SPARTA DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6760
Mailing Address - Country:US
Mailing Address - Phone:281-433-2977
Mailing Address - Fax:
Practice Address - Street 1:3419 SPARTA DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-6760
Practice Address - Country:US
Practice Address - Phone:281-433-2977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-11
Last Update Date:2018-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX381832355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant