Basic Information
Provider Information
NPI: 1003155318
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOVES
FirstName: LOUISE
MiddleName: MCINTYRE
NamePrefix: MS.
NameSuffix:  
Credential: M.A., IMFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MCINTYRE
OtherFirstName: LOUISE
OtherMiddleName: BORJA
OtherNamePrefix: MS.
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 2845
Address2:  
City: HAGATNA
State: GU
PostalCode: 969322845
CountryCode: US
TelephoneNumber: 6714880116
FaxNumber:  
Practice Location
Address1: 1244 N MARINE CORPS DR
Address2:  
City: TAMUNING
State: GU
PostalCode: 969134308
CountryCode: US
TelephoneNumber: 6716478262
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/06/2013
LastUpdateDate: 02/06/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000XIMF000068GUY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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