| Doctor Name: | MRS. LATOYA CHEVELLE WADDELL |
| NPI Number: | 1679817597 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, CRC, LPCA, RLCAS |
| License Number: | A9186 |
| Business Practice Address: | 2031 Martin Luther King Jr Dr Suite E Greensboro, NC - 274063342 |
| Business Phone Number: | 3362715888 |
| Business Fax Number: | 3362715882 |
| Mailing Address: | 5710 Yachtsman Ct, BROWNS SUMMIT |
| State: | NC |
| Postal Code: | 272149090 |
| Phone Number: | 3369879743 |
| Fax Number: | |
| NPI Enumeration Date: | 11/15/2012 |
| NPI Last Update Date: | 11/15/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | A9186 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |