BERTILLE OCTAVIE MAVEGAM TANGO ASSOUMOU M (NPI# 1336694066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336694066 |
| Entity Type | Individual |
| Full Name | BERTILLE OCTAVIE MAVEGAM TANGO ASSOUMOU M |
| Practice Address |
22 Atwood Dr Fl 1 Northampton MA 01060-4267 |
| Practice Telephone | 4135861601 |
| Practice Fax Number | 4139239304 |
| Mailing Telephone | 4135861601 |
| Mailing Fax Number | 4139239304 |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2016-08-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133NN1002X |
Nutritionist Specialization: Nutrition, Education |
Dietary & Nutritional Service Providers |
| Street Address |
22 ATWOOD DR FL 1 |
| City | NORTHAMPTON |
| State | MA |
| Zip Code | 01060-4267 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942869318 | Stephanie Jordan | Counselor | 16 Center St Ste 517, Northampton, MA 01060 | 2019-06-10 |
| 1659853828 | James Drisko | Social Worker | 159 Crescent St, Northampton, MA 01060 | 2018-09-04 |
| 1063994416 | Nancy P Doby | Social Worker | 84 Conz Street, Northampton, MA 01060 | 2018-09-02 |
| 1356821144 | Kathleen Ann Goodwin-boyd | Social Worker | Northampton High School, 380 Elm Street, Northampton, MA 01060 | 2018-08-21 |
| 1457847048 | Kathryn Karusaitis Basham | Social Worker | 155 Main Street C/o Dr. Herzog Phd, Northampton, MA 01060 | 2018-07-06 |
| 1700392289 | Angel Marie Kennedy | Behavioral Analyst | 351 Pleasant St Ste B126, Northampton, MA 01060 | 2017-12-20 |
| 1013437508 | Ricky Jermaine Logan | Counselor | 129 North King Street, Northampton, MA 01060 | 2017-06-26 |
| 1962858886 | Alicia Simoni | Social Worker | 25 Main St Ste 445, Northampton, MA 01060 | 2016-05-10 |
| 1134589708 | James Edmonstone | Clinic/Center | 78 Mainst., Suite 404, Northampton, MA 01060 | 2016-02-25 |
| 1114395639 | Danielle Baker | Speech-Language Pathologist | 228 King St Ste 2, Northampton, MA 01060 | 2015-09-15 |
| Find all providers in zip 01060 | ||||
| Taxonomy Code | 133NN1002X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Nutritionist |
| Specialization | Nutrition, Education |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396353561 | 360girls&women | Nutritionist | 45 Granite St, Hopkinton, MA 01748-2301 | 2020-07-14 |
| 1225592736 | Susan K Phillip | Nutritionist | 67 Glendale St, Dorchester, MA 02125-2404 | 2019-01-29 |
| 1982112470 | Danielle Nicole Shea Tan | Nutritionist | 29 Kenney Rd, Medfield, MA 02052-1805 | 2018-01-18 |
| 1669830808 | Marnie Lawler | Nutritionist | 51 Eastern Ave, Essex, MA 01929-1301 | 2016-02-02 |
| 1861817520 | Patty Rais-keeley Rd, Ldn, Cde, LLC | Nutritionist | 220-1 Reservoir St., Needham Heights, MA 02494 | 2014-03-04 |
| 1346678604 | Giuseppina Cefalo Boatwright | Nutritionist | 50 Mall Rd Ste G03, Burlington, MA 01803-4529 | 2013-10-24 |
| 1477706679 | Head To Fitness, Inc | Nutritionist | 78 Spring St., Medford, MA 02155 | 2008-10-31 |
| 1881840643 | Margaret K Cwieka | Nutritionist | 15 West Bay Rd Unit G, Weight-in-balance, Osterville, MA 02655 | 2008-08-13 |
| 1679738439 | Mary Vindice Marshall | Nutritionist | 78 Spring St, Medford, MA 02155-4855 | 2008-07-22 |
| 1336304112 | Rachel C. Keim | Nutritionist | 9 Russell Rd, Huntington, MA 01050-9776 | 2008-07-22 |
| Find all providers with the same taxonomy | ||||
| City | NORTHAMPTON |
| Zip Code | 01060 |
Please comment or provide details below to improve the information on BERTILLE OCTAVIE MAVEGAM TANGO ASSOUMOU M.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.