Healthcare Provider Details

I. General information

NPI: 1386402725
Provider Name (Legal Business Name): JOANA NANA KONADU TWUM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 S WESTNEDGE AVE
KALAMAZOO MI
49008-3208
US

IV. Provider business mailing address

610 S BURDICK ST
KALAMAZOO MI
49007-5221
US

V. Phone/Fax

Practice location:
  • Phone: 269-459-7821
  • Fax:
Mailing address:
  • Phone:
  • Fax: 269-381-3810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: