Provider Demographics
NPI:1144658501
Name:BABER, LATOYA MARIE
Entity type:Individual
Prefix:
First Name:LATOYA
Middle Name:MARIE
Last Name:BABER
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:P.O, BOX 570734
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:CA
Mailing Address - Zip Code:89157
Mailing Address - Country:US
Mailing Address - Phone:714-515-9157
Mailing Address - Fax:
Practice Address - Street 1:6360 PECOS RD ST 4
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120
Practice Address - Country:US
Practice Address - Phone:714-515-9157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst