Provider Demographics
NPI:1194154427
Name:TWUM, ISAAC
Entity type:Individual
Prefix:MR
First Name:ISAAC
Middle Name:
Last Name:TWUM
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 1:307 PAWTUCKET BLVD
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-2959
Mailing Address - Country:US
Mailing Address - Phone:978-364-1931
Mailing Address - Fax:
Practice Address - Street 1:307 PAWTUCKET BLVD
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-2959
Practice Address - Country:US
Practice Address - Phone:978-364-1931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst