Provider Demographics
NPI:1972819696
Name:MUSHI, PRISCILLAH MOSES
Entity type:Individual
Prefix:
First Name:PRISCILLAH
Middle Name:MOSES
Last Name:MUSHI
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 1:229 S COMMON ST APT 8
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01905-2445
Mailing Address - Country:US
Mailing Address - Phone:781-426-1763
Mailing Address - Fax:
Practice Address - Street 1:229 S COMMON ST APT 8
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01905-2445
Practice Address - Country:US
Practice Address - Phone:781-426-1763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health