Provider Demographics
NPI:1215324942
Name:KIHUMURO, COLMAN COLLINS
Entity type:Individual
Prefix:
First Name:COLMAN
Middle Name:COLLINS
Last Name:KIHUMURO
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 1:131 RANTOUL ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-4240
Mailing Address - Country:US
Mailing Address - Phone:617-247-1001
Mailing Address - Fax:
Practice Address - Street 1:131 RANTOUL ST
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-4240
Practice Address - Country:US
Practice Address - Phone:617-247-1001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)