Grandy-Walker, Latoya
Grandy-Walker, Latoya is an sole proprietor health care provider with primary practice located at 1805 Over Lake Dr Se Ste D , Conyers GA 30013. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Grandy-Walker, Latoya can be contacted via phone (770) 572-5991.Contact Information
Primary practice address
1805 Over Lake Dr Se Ste D
Conyers GA 30013
Phone: (770) 572-5991
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | CSW005086 | Georgia |
Profile Details
| NPI number | 1801212022 |
|---|---|
| LBN Legal business name | Grandy-Walker, Latoya |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 12th, 2014 |
| Last updated | Oct 9th, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801212022 | NPPES |
| Georgia | MEDICAID | 003160476B |
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