Provider Demographics
NPI:1588077044
Name:WALKER, LATASHA AUJENA
Entity type:Individual
Prefix:MRS
First Name:LATASHA
Middle Name:AUJENA
Last Name:WALKER
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 1:501 W 15TH ST
Mailing Address - Street 2:APT#104
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-3643
Mailing Address - Country:US
Mailing Address - Phone:405-431-6471
Mailing Address - Fax:
Practice Address - Street 1:4337 SE15TH
Practice Address - Street 2:
Practice Address - City:DEL CITY
Practice Address - State:OK
Practice Address - Zip Code:73115
Practice Address - Country:US
Practice Address - Phone:405-609-1760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management