Provider Demographics
NPI:1881260735
Name:OSUMANU, CELESTE YVETTE
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:YVETTE
Last Name:OSUMANU
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 1:98 PARK AVE APT B
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07501-5220
Mailing Address - Country:US
Mailing Address - Phone:904-338-3274
Mailing Address - Fax:
Practice Address - Street 1:98 PARK AVE APT B
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07501-5220
Practice Address - Country:US
Practice Address - Phone:904-338-3274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2024-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
21-196196106S00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician