Provider Demographics
NPI:1568297919
Name:OKUMU, ANGEL VIVIENNE (N/A)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:VIVIENNE
Last Name:OKUMU
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:
Other - First Name:ANGELLA
Other - Middle Name:VIVIENNE
Other - Last Name:OKUMU-CREECH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:N/A
Mailing Address - Street 1:54 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ASHBURNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01430-1634
Mailing Address - Country:US
Mailing Address - Phone:978-504-6046
Mailing Address - Fax:
Practice Address - Street 1:975 MERRIAM AVE STE 210
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-1240
Practice Address - Country:US
Practice Address - Phone:888-763-7272
Practice Address - Fax:877-243-2959
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor