SearchTexas364SP0808X

Latonya Polk

NPI 1861551814 · on the registry since 2006 · sole proprietor

Practice

Address
1328 Heritage Blvd
Longview, TX 75605
Phone
(902) 260-0412
Fax
(866) 877-1258
Organisation at this address
Rustic Roots Family Care Pllc
Emmanuel Residential Services
Emmanuel Behavioral Health & Wellness Pllc
Inferred from a shared address, not stated in the registry.

Additional practice sites

  • 205 E Us Highway 80, White Oak, TX
  • 807 S Mobberly Ave, Longview, TX

Registry record

Primary taxonomy
364SP0808X
364SP0808X
Also registered as
261QA0600X
251E00000X
310400000X
320900000X
Licence states on file
TX
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2026-06-30

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas