Provider Demographics
NPI:1508559170
Name:NSHUTI, JEMIMA N/A
Entity Type:Individual
Prefix:
First Name:JEMIMA
Middle Name:N/A
Last Name:NSHUTI
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 1:1826 CREEKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-9028
Mailing Address - Country:US
Mailing Address - Phone:806-340-5767
Mailing Address - Fax:
Practice Address - Street 1:1826 CREEKVIEW DR
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-9028
Practice Address - Country:US
Practice Address - Phone:806-340-5767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities