Provider Demographics
NPI:1023725801
Name:MPOLOKOSO, NAOMI ELIZABETH (RN, LLMSW)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:ELIZABETH
Last Name:MPOLOKOSO
Suffix:
Gender:F
Credentials:RN, LLMSW
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Mailing Address - Street 1:1424 SUMMER RIDGE DR APT E
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-1062
Mailing Address - Country:US
Mailing Address - Phone:352-816-5233
Mailing Address - Fax:
Practice Address - Street 1:1521 GULL RD
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1640
Practice Address - Country:US
Practice Address - Phone:269-226-8133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical