Provider Demographics
NPI:1902637168
Name:HAYNES-THOBY, LATOYA (PHD)
Entity type:Individual
Prefix:DR
First Name:LATOYA
Middle Name:
Last Name:HAYNES-THOBY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CHESTER ST
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-2818
Mailing Address - Country:US
Mailing Address - Phone:860-281-1761
Mailing Address - Fax:
Practice Address - Street 1:200 CHESTER ST
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108-2818
Practice Address - Country:US
Practice Address - Phone:860-281-1761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-09
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6852101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health