| Doctor Name: | MRS. JENNIFER A UGBANAJA |
| NPI Number: | 1043646128 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNS |
| License Number: | PPNS00114 |
| Business Practice Address: | 160 Beechwood Ave Pawtucket, RI - 028605402 |
| Business Phone Number: | 4017225573 |
| Business Fax Number: | |
| Mailing Address: | 309 Greenwich Ave, Apt C225 WARWICK |
| State: | RI |
| Postal Code: | 028861639 |
| Phone Number: | 4014731569 |
| Fax Number: | |
| NPI Enumeration Date: | 09/19/2013 |
| NPI Last Update Date: | 09/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SP0807X |
| License Number: | PPNS00114 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | RI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Psych/Mental Health, Child & Adolescent |
| Taxonomy Definition: | |