Provider Demographics
NPI:1356137871
Name:FUH, CLOVIS KUBIA
Entity type:Individual
Prefix:
First Name:CLOVIS
Middle Name:KUBIA
Last Name:FUH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2667 EVERGREEN RD
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-2310
Mailing Address - Country:US
Mailing Address - Phone:539-252-0599
Mailing Address - Fax:
Practice Address - Street 1:2667 EVERGREEN RD
Practice Address - Street 2:
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-2310
Practice Address - Country:US
Practice Address - Phone:539-252-0599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health