Provider Demographics
NPI:1124374467
Name:DIAMOND, TOYIA RENAE (MHPP)
Entity Type:Individual
Prefix:MRS
First Name:TOYIA
Middle Name:RENAE
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:MHPP
Other - Prefix:MRS
Other - First Name:TOYIA
Other - Middle Name:RENAE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MHPP
Mailing Address - Street 1:1487 W KEISER AVE
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:AR
Mailing Address - Zip Code:72370-2806
Mailing Address - Country:US
Mailing Address - Phone:870-563-4500
Mailing Address - Fax:870-563-4501
Practice Address - Street 1:1487 W KEISER AVE
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:AR
Practice Address - Zip Code:72370-2806
Practice Address - Country:US
Practice Address - Phone:870-563-4500
Practice Address - Fax:870-563-4501
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator