Mavegam Tango Assoumou M, Bertille Octavie

Mavegam Tango Assoumou M, Bertille Octavie is an individual health care provider with primary practice located at 22 Atwood Dr Fl 1 , Northampton MA 01060-4267. She recently has only one registered license in Dietary & Nutritional Service Providers / Nutrition, Education, which is considered as her primary health care specialty. Mavegam Tango Assoumou M, Bertille Octavie can be contacted via phone (413) 586-1601.

Contact Information

Primary practice address
22 Atwood Dr Fl 1 Northampton MA 01060-4267
Phone: (413) 586-1601
Fax: (413) 923-9304
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutrition, Education 133NN1002X

Profile Details

NPI number 1336694066
LBN Legal business name Mavegam Tango Assoumou M, Bertille Octavie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2016
Last updated Aug 23rd, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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