Provider Demographics
NPI:1912397241
Name:SMALLS, LATOYA (MS, BSL)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:
Last Name:SMALLS
Suffix:
Gender:F
Credentials:MS, BSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:492 ROUTE 37 WEST
Mailing Address - Street 2:FAMILY GUIDANCE CENTER OF WARREN COUNTY
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-4411
Mailing Address - Country:US
Mailing Address - Phone:908-689-1000
Mailing Address - Fax:908-689-4529
Practice Address - Street 1:370 MEMORIAL PARKWAY
Practice Address - Street 2:FAMILY GUIDANCE CENTER OF WARREN COUNTY
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1580
Practice Address - Country:US
Practice Address - Phone:908-454-4470
Practice Address - Fax:908-454-5317
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH001067103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst