Provider Demographics
NPI:1659185130
Name:SOALE FUSEINI, MAHANI
Entity type:Individual
Prefix:
First Name:MAHANI
Middle Name:
Last Name:SOALE FUSEINI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 GRANBY RD APT 303
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-1568
Mailing Address - Country:US
Mailing Address - Phone:413-204-6467
Mailing Address - Fax:
Practice Address - Street 1:48 HOLY FAMILY RD APT 303
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-2786
Practice Address - Country:US
Practice Address - Phone:413-204-6467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health