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Individual

MS. TOY ANNE LASTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.ED

Contact information

Practice address
195 BENEDICT CT, ATHENS, GA 30605-2845
(470) 216-6171
Mailing address
195 BENEDICT CT, ATHENS, GA 30605-2845
(470) 216-6171

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
617228811A
GA
Enumeration date
03/17/2007
Last updated
11/10/2014
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