Provider Demographics
NPI:1942811971
Name:ILUNGA, CHRISTELLA
Entity Type:Individual
Prefix:
First Name:CHRISTELLA
Middle Name:
Last Name:ILUNGA
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 1:4 BARLOWS LANDING RD STE 13
Mailing Address - Street 2:
Mailing Address - City:POCASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02559-1984
Mailing Address - Country:US
Mailing Address - Phone:508-563-5767
Mailing Address - Fax:
Practice Address - Street 1:2 7 7 7 7 INKSTER RD STE 100
Practice Address - Street 2:
Practice Address - City:F A R M I N G T O N H I L L S
Practice Address - State:MI
Practice Address - Zip Code:48334
Practice Address - Country:US
Practice Address - Phone:248-221-1842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician