Provider Demographics
NPI:1407105752
Name:NORTH CLOUD, BEAVER TOYA (BA SOCIAL SCIENCE)
Entity Type:Individual
Prefix:MS
First Name:BEAVER
Middle Name:TOYA
Last Name:NORTH CLOUD
Suffix:
Gender:F
Credentials:BA SOCIAL SCIENCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 PALOMAS DR SE
Mailing Address - Street 2:APT. 1
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-5541
Mailing Address - Country:US
Mailing Address - Phone:505-269-6767
Mailing Address - Fax:
Practice Address - Street 1:1104 PALOMAS DR SE
Practice Address - Street 2:APT. 1
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-5541
Practice Address - Country:US
Practice Address - Phone:505-269-6767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-31
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator