Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service | ||
N | 103TH0100X | Health Service | TX |
NPI | 1235724519 |
---|---|
Provider Name | Latonya Tonoa Haley |
First Address | Spring, TX 77386-3295 |
Second Address | Spring, TX 77386-3295 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2021 |
Last Update Date | 08/03/2021 |