MEDICARE: DR. AMOS E. OZUMBA ED.D, LMSW-AP,LCDC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	02069	TX
2	251B00000X	Case Management Agency	02069	TX
3	171M00000X	Case Manager/Care Coordinator	02069	TX

General Provider Information

NPI Number	:	1669536215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMOS E. OZUMBA ED.D, LMSW-AP,LCDC

Provider Business Mailing Address
First Line	:	6423 OAKHAM ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77085-2402
Country	:	US
Telephone Number	:	713-527-0064
Fax Number	:	713-527-8633

Provider Business Practice Location Address
First Line	:	176 UVALDE RD
Second Line	:	4608 MAIN
City	:	HOUSTON
State	:	TX
Zip	:	77015-1506
Country	:	US
Telephone Number	:	713-455-7008
Fax Number	:	713-455-4870

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	11/26/2007

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