Provider Demographics
NPI:1538931324
Name:WILLIAMS, LATOYA SHAKETA
Entity type:Individual
Prefix:
First Name:LATOYA
Middle Name:SHAKETA
Last Name:WILLIAMS
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 1:613 WALNUT STREET
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707
Mailing Address - Country:US
Mailing Address - Phone:989-356-6649
Mailing Address - Fax:
Practice Address - Street 1:16298 JAKES RD
Practice Address - Street 2:
Practice Address - City:LACHINE
Practice Address - State:MI
Practice Address - Zip Code:49753-9202
Practice Address - Country:US
Practice Address - Phone:517-395-9319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)