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Provider Information for 1730682428


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Ms. KAMALA A ORUAMABO LMHC


Sex: Female

NPI: 1730682428
Last Updated: 2021-05-28
Certification Date: 2021-05-28

Details

NameValue
NPI1730682428
Enumeration Date2018-03-09
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 120 KING ST
JACKSONVILLE, FL 32204-2410
United States

Phone: 904-800-6347 | Fax:
 
Primary Practice Address 120 KING ST
JACKSONVILLE, FL 32204-2410
United States

Phone: 904-914-9074 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDFL022996100
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthFLMH18879