Provider Demographics
NPI:1811248156
Name:FISHER, LATANYA DANYEL
Entity type:Individual
Prefix:MS
First Name:LATANYA
Middle Name:DANYEL
Last Name:FISHER
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 1:8446 GALLAHAD ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77078-2849
Mailing Address - Country:US
Mailing Address - Phone:832-297-0463
Mailing Address - Fax:832-297-0463
Practice Address - Street 1:8446 GALLAHAD ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77078-2849
Practice Address - Country:US
Practice Address - Phone:832-297-0463
Practice Address - Fax:832-297-0463
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility