Individual
DANIEL OMOAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1115 W CHESTNUT ST, BROCKTON, MA 02301-7501
(508) 223-4691
(508) 580-5162
Mailing address
1115 W CHESTNUT ST, BROCKTON, MA 02301-7501
(508) 580-4691
(508) 580-5162
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CSW00760
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104847946
THE PROVIDENCE CENTER NPI
RI
01
—
1912942202
UBH
RI
05
—
DO45951
—
RI
Enumeration date
06/19/2006
Last updated
07/27/2012
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