Provider Demographics
NPI:1720843592
Name:NAKANWAGI, JAMILLAH
Entity Type:Individual
Prefix:
First Name:JAMILLAH
Middle Name:
Last Name:NAKANWAGI
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 1:82 BRICK KILN RD
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-3239
Mailing Address - Country:US
Mailing Address - Phone:781-825-3396
Mailing Address - Fax:
Practice Address - Street 1:82 BRICK KILN RD
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-3239
Practice Address - Country:US
Practice Address - Phone:781-825-3396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health