Provider Demographics
NPI:1437495082
Name:MCINTOSH, ONEDIA NATASHA
Entity Type:Individual
Prefix:
First Name:ONEDIA
Middle Name:NATASHA
Last Name:MCINTOSH
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:PO BOX 9272
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31908-9272
Mailing Address - Country:US
Mailing Address - Phone:706-442-2189
Mailing Address - Fax:
Practice Address - Street 1:1528 WILDWOOD AVE
Practice Address - Street 2:433
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-2099
Practice Address - Country:US
Practice Address - Phone:706-442-2189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-28
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator