Provider Demographics
NPI:1518382027
Name:DIAWARA, TONIA M
Entity Type:Individual
Prefix:MRS
First Name:TONIA
Middle Name:M
Last Name:DIAWARA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:TONIA
Other - Middle Name:M
Other - Last Name:DIAWARA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DIRECT CARE GIVER
Mailing Address - Street 1:4900 FULLER DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1732
Mailing Address - Country:US
Mailing Address - Phone:614-302-1659
Mailing Address - Fax:
Practice Address - Street 1:4900 FULLER DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1732
Practice Address - Country:US
Practice Address - Phone:614-302-1659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH253Z00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care