Mack, Latoy

Mack, Latoy is an sole proprietor health care provider with primary practice located at 2510 1St Ave S , St Petersburg FL 33712-1106. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Mack, Latoy can be contacted via phone (727) 289-1164.

Contact Information

Primary practice address
2510 1St Ave S St Petersburg FL 33712-1106
Phone: (727) 289-1164
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X IMH9624 Florida

Profile Details

NPI number 1962741140
LBN Legal business name Mack, Latoy
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 7th, 2013
Last updated Feb 7th, 2013 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962741140 NPPES
Florida MEDICAID 003243100

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