Provider Demographics
NPI:1114538956
Name:NAMIREMBE SERWANGA, MARIAM N (HOME HEALTH AIDE)
Entity Type:Individual
Prefix:
First Name:MARIAM
Middle Name:N
Last Name:NAMIREMBE SERWANGA
Suffix:
Gender:F
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 NORTH RD UNIT 84
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-1425
Mailing Address - Country:US
Mailing Address - Phone:857-880-9459
Mailing Address - Fax:
Practice Address - Street 1:255 NORTH RD UNIT 84
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-1425
Practice Address - Country:US
Practice Address - Phone:857-880-9459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor