Healthcare Provider Details

I. General information

NPI: 1093395378
Provider Name (Legal Business Name): TRASHEDA K. TOLIVER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 MYERS ST
MINDEN LA
71055-4933
US

IV. Provider business mailing address

403 MYERS ST
MINDEN LA
71055-4933
US

V. Phone/Fax

Practice location:
  • Phone: 318-377-2742
  • Fax: 318-377-3879
Mailing address:
  • Phone: 318-377-2742
  • Fax: 318-377-3879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPLC10841
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: