Provider Demographics
NPI:1093538795
Name:BOKUM, LAMRANA
Entity type:Individual
Prefix:
First Name:LAMRANA
Middle Name:
Last Name:BOKUM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10038 DUBARRY ST
Mailing Address - Street 2:
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-9248
Mailing Address - Country:US
Mailing Address - Phone:610-604-8563
Mailing Address - Fax:
Practice Address - Street 1:10038 DUBARRY ST
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9248
Practice Address - Country:US
Practice Address - Phone:610-604-8563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-02
Last Update Date:2024-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty