Individual
LATONYA WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4919 JAMESTOWN AVE STE 101D, BATON ROUGE, LA 70808
(225) 268-2254
Mailing address
2751 WOODDALE BLVD, BATON ROUGE, LA 70805-7567
(225) 359-9315
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000000
—
LA
Enumeration date
09/08/2016
Last updated
12/19/2023
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