Provider Demographics
NPI:1598571549
Name:DUNMORE, LATOYA
Entity type:Individual
Prefix:
First Name:LATOYA
Middle Name:
Last Name:DUNMORE
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 1:1032 MARTIN LUTHER KING DR
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71295-4049
Mailing Address - Country:US
Mailing Address - Phone:601-431-6225
Mailing Address - Fax:
Practice Address - Street 1:201 N. EE WALLACE BLVD., SUITE 3
Practice Address - Street 2:
Practice Address - City:FERRIDAY
Practice Address - State:LA
Practice Address - Zip Code:71334-2821
Practice Address - Country:US
Practice Address - Phone:318-757-0016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator