Doctor Name: | ISOKEN IYAMU-OSAGIE |
NPI Number: | 1386089548 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW |
License Number: | |
Business Practice Address: | 1007 N Main St Dayville, CT - 062412170 |
Business Phone Number: | 8607742020 |
Business Fax Number: | 8607745476 |
Mailing Address: | 1007 N Main St, DAYVILLE |
State: | CT |
Postal Code: | 062412170 |
Phone Number: | 8607742020 |
Fax Number: | 8607745476 |
NPI Enumeration Date: | 05/01/2013 |
NPI Last Update Date: | 05/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |