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General NPI Number Information
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NPI Number | 1104463231
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Entity Type | Individual
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Provider Name | NAJJA CUMMINGS
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Gender | Male
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Dates
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Enumeration Date | 12/09/2019
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Last Update Date | 10/29/2021
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Provider Practice Location Address
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Address Line | 15820 KNOLL TRAIL DR APT 304
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City | DALLAS
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State | TX
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Zip | 75248-2771
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Country | US
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Telephone | 813-907-9736
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Fax |
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Provider Business Mailing Address
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Address Line | 3820 COLONIAL BLVD STE 200
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City | FORT MYERS
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State | FL
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Zip | 33966-1094
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | FL
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