Provider Demographics
NPI:1285440578
Name:UMOH, DEBORAH ANIEKAN
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANIEKAN
Last Name:UMOH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 HOLLINGER WAY
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-9011
Mailing Address - Country:US
Mailing Address - Phone:404-437-3276
Mailing Address - Fax:
Practice Address - Street 1:170 HOLLINGER WAY
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-9011
Practice Address - Country:US
Practice Address - Phone:404-437-3276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician