Individual
AGUNYENWA I NNOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 W CHESTNUT ST, BROCKTON, MA 02301-7501
(508) 521-2200
Mailing address
1115 W CHESTNUT ST, BROCKTON, MA 02301-7501
(508) 521-2200
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265E
—
MA
Enumeration date
05/10/2018
Last updated
04/24/2020
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