Provider Demographics
NPI:1891672580
Name:AMONOO-NEIZER, KWAMINA
Entity type:Individual
Prefix:
First Name:KWAMINA
Middle Name:
Last Name:AMONOO-NEIZER
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 1:1445 E WOODBURY RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-1555
Mailing Address - Country:US
Mailing Address - Phone:312-388-4177
Mailing Address - Fax:
Practice Address - Street 1:1445 E WOODBURY RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-1555
Practice Address - Country:US
Practice Address - Phone:312-388-4177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-16
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist