Provider Demographics
NPI:1932297348
Name:TOYA, ELEANOR P (SW)
Entity Type:Individual
Prefix:MS
First Name:ELEANOR
Middle Name:P
Last Name:TOYA
Suffix:
Gender:F
Credentials:SW
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 130
Mailing Address - Street 2:ACOMA CANONCITO LABRUNIA INDIAN HOSP
Mailing Address - City:SAN FIDEL
Mailing Address - State:NM
Mailing Address - Zip Code:87049
Mailing Address - Country:US
Mailing Address - Phone:505-552-5315
Mailing Address - Fax:505-552-5491
Practice Address - Street 1:EXIT I 40 EXIT 102
Practice Address - Street 2:ACL HOSPITAL
Practice Address - City:SAN FIDEL
Practice Address - State:NM
Practice Address - Zip Code:87049
Practice Address - Country:US
Practice Address - Phone:505-552-5315
Practice Address - Fax:505-552-5491
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM2460104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM92936067Medicaid
NM320070Medicare ID - Type Unspecified