Provider Demographics
NPI:1760242952
Name:KUMAUS, GABRIEL MICHAEL
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:MICHAEL
Last Name:KUMAUS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6196 NORMANDY DR APT 5
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-4345
Mailing Address - Country:US
Mailing Address - Phone:989-877-1092
Mailing Address - Fax:
Practice Address - Street 1:6196 NORMANDY DR APT 5
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-4345
Practice Address - Country:US
Practice Address - Phone:989-877-1092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician