Provider Demographics
NPI:1184942435
Name:SWINK, TOSHA ADELE (LOTR)
Entity type:Individual
Prefix:MISS
First Name:TOSHA
Middle Name:ADELE
Last Name:SWINK
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15603 GRAZIANO LN
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-7269
Mailing Address - Country:US
Mailing Address - Phone:985-351-0045
Mailing Address - Fax:
Practice Address - Street 1:15603 GRAZIANO LN
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-7269
Practice Address - Country:US
Practice Address - Phone:985-351-0045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-11
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.200136225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist