Provider Demographics
NPI:1215628722
Name:STOKER, LATOSHA
Entity type:Individual
Prefix:
First Name:LATOSHA
Middle Name:
Last Name:STOKER
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 1:4579 EVERHARD RD NW STE A
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2425
Mailing Address - Country:US
Mailing Address - Phone:330-227-6768
Mailing Address - Fax:
Practice Address - Street 1:4579 EVERHARD RD NW STE A
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2425
Practice Address - Country:US
Practice Address - Phone:330-305-1668
Practice Address - Fax:330-305-1696
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2309525104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker