Provider Demographics
NPI:1639486566
Name:DWUMFUOH, TAKYI (LMFT 103566)
Entity Type:Individual
Prefix:MR
First Name:TAKYI
Middle Name:
Last Name:DWUMFUOH
Suffix:
Gender:M
Credentials:LMFT 103566
Other - Prefix:MR
Other - First Name:TAKYI
Other - Middle Name:
Other - Last Name:DWUMFUOH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:IMF
Mailing Address - Street 1:675 TEXAS ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-6372
Mailing Address - Country:US
Mailing Address - Phone:707-784-4732
Mailing Address - Fax:
Practice Address - Street 1:675 TEXAS ST STE 3800
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-6372
Practice Address - Country:US
Practice Address - Phone:707-784-2228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103566106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist