Provider Demographics
NPI:1437901410
Name:AQUI, TOSHA B
Entity Type:Individual
Prefix:
First Name:TOSHA
Middle Name:B
Last Name:AQUI
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 1:1899 APPALOOSA MILL CIR
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-6612
Mailing Address - Country:US
Mailing Address - Phone:167-833-2892
Mailing Address - Fax:
Practice Address - Street 1:2336 WISTERIA DR STE 440
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6160
Practice Address - Country:US
Practice Address - Phone:770-733-1469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty