Provider Demographics
NPI:1447810437
Name:OWUSU, JACQUELINE OSEI
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:OSEI
Last Name:OWUSU
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 1:36 18TH ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01850-1304
Mailing Address - Country:US
Mailing Address - Phone:917-773-7739
Mailing Address - Fax:
Practice Address - Street 1:1501 MAIN ST STE 29
Practice Address - Street 2:
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-4700
Practice Address - Country:US
Practice Address - Phone:774-266-8645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst