Provider Demographics
NPI:1518756345
Name:MOMO NOUMEDEM, VIALI FRANCK
Entity type:Individual
Prefix:
First Name:VIALI FRANCK
Middle Name:
Last Name:MOMO NOUMEDEM
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 1:152 N 32ND ST APT 28
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68503-3414
Mailing Address - Country:US
Mailing Address - Phone:914-604-0733
Mailing Address - Fax:
Practice Address - Street 1:152 N 32ND ST APT 28
Practice Address - Street 2:152 N 32ND ST APT 28
Practice Address - City:LICOLN
Practice Address - State:NE
Practice Address - Zip Code:68503-6850
Practice Address - Country:US
Practice Address - Phone:914-604-0733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily