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General NPI Number Information
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NPI Number | 1598519654
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Entity Type | Individual
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Provider Name | KWABENA YAMOAH
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Gender | Male
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Dates
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Enumeration Date | 04/15/2024
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Last Update Date | 04/15/2024
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Provider Practice Location Address
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Address Line | 1505 E 53RD ST # 2E
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City | CHICAGO
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State | IL
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Zip | 60615-4509
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Country | US
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Telephone | 312-487-3791
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Fax |
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Provider Business Mailing Address
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Address Line | 6 16TH ST
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-1820
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Country | US
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Telephone | 908-337-1298
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178.017467
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License Number State | IL
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