Provider Demographics
NPI:1831650605
Name:NWUFOH, JOSEPH N
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:N
Last Name:NWUFOH
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 1:1615 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71202-2029
Mailing Address - Country:US
Mailing Address - Phone:318-512-2857
Mailing Address - Fax:
Practice Address - Street 1:1615 JACKSON ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71202-2029
Practice Address - Country:US
Practice Address - Phone:318-512-2857
Practice Address - Fax:318-388-4961
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician