Provider Demographics
NPI:1063205151
Name:OMAR, NAFISO O
Entity type:Individual
Prefix:
First Name:NAFISO
Middle Name:O
Last Name:OMAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NAFISO
Other - Middle Name:O
Other - Last Name:OMAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2832 MORALITY DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-8827
Mailing Address - Country:US
Mailing Address - Phone:614-599-6322
Mailing Address - Fax:
Practice Address - Street 1:2832 MORALITY DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-8827
Practice Address - Country:US
Practice Address - Phone:614-599-6322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician