Provider Demographics
NPI:1245548031
Name:TOTH, REBECCA SUE
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:SUE
Last Name:TOTH
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:BECKY
Other - Middle Name:SUE
Other - Last Name:TOTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1939 DIVISION AVE S
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49507-2459
Mailing Address - Country:US
Mailing Address - Phone:616-247-3815
Mailing Address - Fax:616-988-1481
Practice Address - Street 1:1939 DIVISION AVE S
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49507-2459
Practice Address - Country:US
Practice Address - Phone:616-247-3815
Practice Address - Fax:616-988-1481
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical