Provider Demographics
NPI:1033668413
Name:IDEWU, TOYIN
Entity Type:Individual
Prefix:
First Name:TOYIN
Middle Name:
Last Name:IDEWU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4943 REDWOOD ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-3650
Mailing Address - Country:US
Mailing Address - Phone:504-701-7543
Mailing Address - Fax:504-701-7543
Practice Address - Street 1:4943 REDWOOD ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-3650
Practice Address - Country:US
Practice Address - Phone:504-701-7543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-27
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health