Provider Demographics
NPI:1134417918
Name:EZUMAH, ANULI JOSEPHINE
Entity type:Individual
Prefix:
First Name:ANULI
Middle Name:JOSEPHINE
Last Name:EZUMAH
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 1:2122 RIDGEWORTH LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-6422
Mailing Address - Country:US
Mailing Address - Phone:713-371-6089
Mailing Address - Fax:281-232-2757
Practice Address - Street 1:2122 RIDGEWORTH LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-6422
Practice Address - Country:US
Practice Address - Phone:713-371-6089
Practice Address - Fax:281-232-2757
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities