Provider Demographics
NPI:1376262915
Name:AKAYEZU, JEAN PIERRE N/A
Entity Type:Individual
Prefix:
First Name:JEAN PIERRE
Middle Name:N/A
Last Name:AKAYEZU
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 1:4 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-3632
Mailing Address - Country:US
Mailing Address - Phone:207-409-9804
Mailing Address - Fax:
Practice Address - Street 1:4 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-3632
Practice Address - Country:US
Practice Address - Phone:207-409-9804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities