Nnoli, Agunyenwa I
Nnoli, Agunyenwa I is an individual health care provider with primary practice located at 1115 W Chestnut St , Brockton MA 02301-7501. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Nnoli, Agunyenwa I can be contacted via phone (508) 521-2200.Contact Information
Primary practice address
1115 W Chestnut St
Brockton MA 02301-7501
Phone: (508) 521-2200
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / School | 1041S0200X |
Profile Details
| NPI number | 1417446949 |
|---|---|
| LBN Legal business name | Nnoli, Agunyenwa I |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 10th, 2018 |
| Last updated | Apr 24th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417446949 | NPPES |
| Massachusetts | MEDICAID | 110026265E |
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