Provider Demographics
NPI:1356578884
Name:UMOH, UDO R
Entity type:Individual
Prefix:MR
First Name:UDO
Middle Name:R
Last Name:UMOH
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 1:117 BARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-3213
Mailing Address - Country:US
Mailing Address - Phone:215-681-3399
Mailing Address - Fax:
Practice Address - Street 1:117 BARRINGTON RD
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-3213
Practice Address - Country:US
Practice Address - Phone:215-681-3399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health