Healthcare Provider Details

I. General information

NPI: 1326259482
Provider Name (Legal Business Name): UMU LAMARANA JALLOH HHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3635 AMBER CLB
COLUMBUS OH
43219-3175
US

IV. Provider business mailing address

3635 AMBER CLB
COLUMBUS OH
43219-3175
US

V. Phone/Fax

Practice location:
  • Phone: 614-622-7354
  • Fax:
Mailing address:
  • Phone: 614-622-7354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License NumberSN6224488
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: