Provider Demographics
NPI:1699956417
Name:UMEH, DOROTHY C (BS,MBA)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:C
Last Name:UMEH
Suffix:
Gender:F
Credentials:BS,MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5208 COUNTRY PINES CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-5688
Mailing Address - Country:US
Mailing Address - Phone:919-208-5733
Mailing Address - Fax:919-876-4139
Practice Address - Street 1:5208 COUNTRY PINES CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-5688
Practice Address - Country:US
Practice Address - Phone:919-208-5733
Practice Address - Fax:919-876-4139
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-092-692320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities