Provider Demographics
NPI:1861738221
Name:HIGH, LATOYA SAMARA
Entity type:Individual
Prefix:
First Name:LATOYA
Middle Name:SAMARA
Last Name:HIGH
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 1:500 N MERIDIAN AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-5700
Mailing Address - Country:US
Mailing Address - Phone:405-601-7367
Mailing Address - Fax:405-604-8010
Practice Address - Street 1:500 N MERIDIAN AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-5700
Practice Address - Country:US
Practice Address - Phone:405-601-7367
Practice Address - Fax:405-604-8010
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor