Provider Demographics
NPI:1669341350
Name:CROCKTON, LATOYA MICHELLE
Entity type:Individual
Prefix:
First Name:LATOYA
Middle Name:MICHELLE
Last Name:CROCKTON
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 1:241B CHARWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:IRONDEQUOIT
Mailing Address - State:NY
Mailing Address - Zip Code:14609-2703
Mailing Address - Country:US
Mailing Address - Phone:585-370-7386
Mailing Address - Fax:
Practice Address - Street 1:241B CHARWOOD CIR
Practice Address - Street 2:
Practice Address - City:IRONDEQUOIT
Practice Address - State:NY
Practice Address - Zip Code:14609-2703
Practice Address - Country:US
Practice Address - Phone:585-370-7386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-01
Last Update Date:2025-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula