Provider Demographics
NPI:1831067446
Name:FRITTS-BRAXTON, LATOYA DENISE
Entity type:Individual
Prefix:
First Name:LATOYA
Middle Name:DENISE
Last Name:FRITTS-BRAXTON
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 1:61 BRASFIELD RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:AL
Mailing Address - Zip Code:35441-2726
Mailing Address - Country:US
Mailing Address - Phone:205-905-0814
Mailing Address - Fax:
Practice Address - Street 1:61 BRASFIELD RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:AL
Practice Address - Zip Code:35441-2726
Practice Address - Country:US
Practice Address - Phone:205-905-0814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-27
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician