Provider Demographics
NPI:1578358131
Name:KIRUMIRA, EDDIE M
Entity type:Individual
Prefix:
First Name:EDDIE
Middle Name:M
Last Name:KIRUMIRA
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 1:7672 W BETTY ELYSE LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-3835
Mailing Address - Country:US
Mailing Address - Phone:602-723-8823
Mailing Address - Fax:
Practice Address - Street 1:1430 OLIVE ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63103-2360
Practice Address - Country:US
Practice Address - Phone:314-645-6840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical