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LATONYA WALLACE-HARDIMAN BA, MSA
NPI 1053818039
Clinic/Center - Pain in Detroit, MI

Active since April 06, 2018
5830 CONNER ST, DETROIT, MI 48213(313) 924-1456(313) 636-2290 Get Directions Write a Review

NPPES record last updated: December 17, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Latonya Wallace-hardiman Ba, Msa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LATONYA WALLACE-HARDIMAN BA, MSA (NPI 1053818039) is an individual pain provider in Detroit, Michigan and active in the NPI registry since April 2018.

NPPES Registry Identity

NPI1053818039
Entity TypeIndividualFemale
Primary Taxonomy261QP3300X
Provider Legal NameLATONYA WALLACE-HARDIMANCredential: BA, MSA
Location Address5830 CONNER STDetroit, MI 48213-3458
Mailing Address162 Sand Bar LnDetroit, MI 48214-8034 · (313) 715-7170 · Fax (313) 636-2290
Phone(313) 924-1456
Fax(313) 636-2290
Sole ProprietorYes
Enumeration DateApril 6, 2018
Last NPPES UpdateDecember 17, 2020
NPPES CertifiedDecember 17, 2020
✔ NPI 1053818039 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · PainAmbulatory Health Care Facilities
Taxonomy Code261QP3300X
5830 CONNER ST, Detroit, MI 48213
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Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LIFE- ALYSIS KIDNEY CENTER, LLC
Health Maintenance Organization
5830 CONNER ST
DETROIT, MI 48213
Wayne County (313) 371-5433
ONE STEP AT A TIME PHYSICAL THERAPY, L.L.C.
Clinic/Center (Physical Therapy)
5830 CONNER ST
DETROIT, MI 48213
Wayne County (313) 499-8494
WOODWARD BOULEVARD MEDICAL BUILDING
Clinic/Center
5830 CONNER ST
DETROIT, MI 48213
Wayne County (313) 924-1456
PRASHANTI BACHU FRANKLIN MD
Family Medicine
5830 CONNER ST
DETROIT, MI 48213
Wayne County (313) 458-8804

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Latonya Wallace-hardiman's NPI number?

The NPI number for Latonya Wallace-hardiman is 1053818039. It was assigned to this individual provider in the NPPES registry on April 6, 2018.

Where is Latonya Wallace-hardiman located?

Latonya Wallace-hardiman practices at 5830 Conner St, Detroit, MI 48213. The listed phone number is (313) 924-1456.

What is Latonya Wallace-hardiman's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Pain, with taxonomy code 261QP3300X.

When was this NPI record last updated?

The NPPES record for Latonya Wallace-hardiman was last updated on December 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.