Provider Demographics
NPI:1508739582
Name:SWACK, LATOYA
Entity type:Individual
Prefix:
First Name:LATOYA
Middle Name:
Last Name:SWACK
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 1:6131 NW 43RD WAY
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-2027
Mailing Address - Country:US
Mailing Address - Phone:630-518-7088
Mailing Address - Fax:
Practice Address - Street 1:6131 NW 43RD WAY
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-2027
Practice Address - Country:US
Practice Address - Phone:630-518-7088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach