Healthcare Provider Details

I. General information

NPI: 1669287884
Provider Name (Legal Business Name): TOYA A HARDY AAS, CDCA ,QMHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

371 W 1ST ST
DAYTON OH
45402-3012
US

IV. Provider business mailing address

371 W 1ST ST
DAYTON OH
45402-3012
US

V. Phone/Fax

Practice location:
  • Phone: 937-558-8567
  • Fax:
Mailing address:
  • Phone: 937-558-8567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.18831
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: