Provider Demographics
NPI:1437772639
Name:TOMS, GENEVA SHEREE (MS)
Entity Type:Individual
Prefix:
First Name:GENEVA
Middle Name:SHEREE
Last Name:TOMS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 CAMDEN HL
Mailing Address - Street 2:
Mailing Address - City:HAUGHTON
Mailing Address - State:LA
Mailing Address - Zip Code:71037-8779
Mailing Address - Country:US
Mailing Address - Phone:318-533-4112
Mailing Address - Fax:
Practice Address - Street 1:301 CAMDEN HL
Practice Address - Street 2:
Practice Address - City:HAUGHTON
Practice Address - State:LA
Practice Address - Zip Code:71037-8779
Practice Address - Country:US
Practice Address - Phone:318-533-4112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator