Provider Demographics
NPI:1710685862
Name:NAKAWEESA, SUSAN NTEGE
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:NTEGE
Last Name:NAKAWEESA
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 1:235 N ANTLERS PL
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-2779
Mailing Address - Country:US
Mailing Address - Phone:302-650-3744
Mailing Address - Fax:
Practice Address - Street 1:99 PASSMORE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-1548
Practice Address - Country:US
Practice Address - Phone:302-478-9411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0011355101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health