Provider Demographics
NPI:1558806166
Name:DLAMINI, KHUMBUZILE
Entity Type:Individual
Prefix:
First Name:KHUMBUZILE
Middle Name:
Last Name:DLAMINI
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 1:53091 MEMORIAL ST
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92532-1569
Mailing Address - Country:US
Mailing Address - Phone:815-325-4601
Mailing Address - Fax:
Practice Address - Street 1:53091 MEMORIAL ST
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92532-1569
Practice Address - Country:US
Practice Address - Phone:815-325-4601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health