Provider Demographics
NPI:1164600094
Name:BASSEY, UMO NKEREUWEM
Entity Type:Individual
Prefix:MRS
First Name:UMO
Middle Name:NKEREUWEM
Last Name:BASSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8080 INNISBROOK CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-2089
Mailing Address - Country:US
Mailing Address - Phone:706-563-1083
Mailing Address - Fax:
Practice Address - Street 1:8080 INNISBROOK CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-2089
Practice Address - Country:US
Practice Address - Phone:706-536-7235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker