Provider Demographics
NPI:1699133165
Name:GUILLORY, LA'TOYA (MA)
Entity type:Individual
Prefix:MRS
First Name:LA'TOYA
Middle Name:
Last Name:GUILLORY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 181
Mailing Address - Street 2:
Mailing Address - City:GRAND COTEAU
Mailing Address - State:LA
Mailing Address - Zip Code:70541-0181
Mailing Address - Country:US
Mailing Address - Phone:337-662-3737
Mailing Address - Fax:337-662-3636
Practice Address - Street 1:123 CHURCH ST.
Practice Address - Street 2:
Practice Address - City:GRAND COTEAU
Practice Address - State:LA
Practice Address - Zip Code:70541-7054
Practice Address - Country:US
Practice Address - Phone:337-662-3737
Practice Address - Fax:337-662-3636
Is Sole Proprietor?:No
Enumeration Date:2016-01-29
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker