Provider Demographics
NPI:1518633544
Name:MUTURI, JANE
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:MUTURI
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 1:228 FINCH WAY
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-4275
Mailing Address - Country:US
Mailing Address - Phone:610-457-4592
Mailing Address - Fax:
Practice Address - Street 1:228 FINCH WAY
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-4275
Practice Address - Country:US
Practice Address - Phone:610-457-4592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities