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General NPI Number Information
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NPI Number | 1265953897
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Entity Type | Individual
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Provider Name | NAOMI ADDAI-MIREKU
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Gender | Female
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Dates
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Enumeration Date | 07/05/2017
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Last Update Date | 07/07/2017
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Provider Practice Location Address
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Address Line | 321 FORTUNE BLVD
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City | MILFORD
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State | MA
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Zip | 01757-1750
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Country | US
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Telephone | 508-478-0207
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Fax |
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Provider Business Mailing Address
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Address Line | 62 LAWTON ST
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City | SPRINGFIELD
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State | MA
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Zip | 01109-2031
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Country | US
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Telephone | 14138856745
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Fax | 141-388-5674
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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 | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State | MA
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