Provider Demographics
NPI:1578947115
Name:KALUMA, ROSETTE (MS-PREP)
Entity Type:Individual
Prefix:
First Name:ROSETTE
Middle Name:
Last Name:KALUMA
Suffix:
Gender:F
Credentials:MS-PREP
Other - Prefix:
Other - First Name:DOROSELLA
Other - Middle Name:ROSETTE NATENDO
Other - Last Name:KALUMA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS-PREP
Mailing Address - Street 1:454 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-3034
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:454 BROADWAY
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-3034
Practice Address - Country:US
Practice Address - Phone:781-485-8222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health