Provider Demographics
NPI:1114606019
Name:NJONJO, WILLIAM MUAMBO
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:MUAMBO
Last Name:NJONJO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 OLENTANGY RESERVE PL
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-8545
Mailing Address - Country:US
Mailing Address - Phone:614-230-4706
Mailing Address - Fax:
Practice Address - Street 1:608 OLENTANGY RESERVE PL
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-8545
Practice Address - Country:US
Practice Address - Phone:614-230-4706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral