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Individual

LATANYA IDELLA WISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1120 HORACE ST STE G13, TOLEDO, OH 43606-4737
(419) 909-2332
Mailing address
PO BOX 3032, TOLEDO, OH 43607-0032

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
OH
101YM0800X
Mental Health Counselor
Primary
OH
171M00000X
Case Manager/Care Coordinator
OH
171M00000X
Case Manager/Care Coordinator
251S00000X
Community/Behavioral Health Agency
OH
251S00000X
Community/Behavioral Health Agency
253Z00000X
In Home Supportive Care Agency
OH
253Z00000X
In Home Supportive Care Agency
3747P1801X
Personal Care Attendant
OH
376J00000X
Homemaker
Primary
385H00000X
Respite Care
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0178373
OH
Enumeration date
01/07/2026
Last updated
06/09/2026
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