Provider Demographics
NPI:1033086632
Name:TUKURA, JERUSALEM NYIZOFO (EDS, NCSP)
Entity type:Individual
Prefix:
First Name:JERUSALEM
Middle Name:NYIZOFO
Last Name:TUKURA
Suffix:
Gender:F
Credentials:EDS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7710 HAYNES POINT WAY UNIT E
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-6017
Mailing Address - Country:US
Mailing Address - Phone:701-500-9813
Mailing Address - Fax:
Practice Address - Street 1:8909 RIGGS RD
Practice Address - Street 2:
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-1633
Practice Address - Country:US
Practice Address - Phone:301-408-6860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool