Provider Demographics
NPI:1174069462
Name:LAING, TOYEA
Entity type:Individual
Prefix:
First Name:TOYEA
Middle Name:
Last Name:LAING
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 1:3952 ROCKBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-4170
Mailing Address - Country:US
Mailing Address - Phone:404-499-8369
Mailing Address - Fax:404-748-1341
Practice Address - Street 1:3952 ROCKBRIDGE RD
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-4170
Practice Address - Country:US
Practice Address - Phone:404-499-8369
Practice Address - Fax:404-748-1341
Is Sole Proprietor?:No
Enumeration Date:2017-01-11
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAADC000136172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker