Provider Demographics
NPI:1275932154
Name:TOLIVER, CHARLOTTE A (RECREATION THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:A
Last Name:TOLIVER
Suffix:
Gender:F
Credentials:RECREATION THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16710 QUAIL VIEW CT
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-5707
Mailing Address - Country:US
Mailing Address - Phone:281-658-4025
Mailing Address - Fax:
Practice Address - Street 1:16710 QUAIL VIEW CT
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-5707
Practice Address - Country:US
Practice Address - Phone:281-658-4025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-18
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253Z00000X, 171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No253Z00000XAgenciesIn Home Supportive Care