Individual ProviderAnnette Kazibwe NazziwaSocial WorkerBehavioral Health & Social Service ProvidersPractice Address30 Dimock St, Roxbury, MA 02119(617) 989-2938PECOS EnrollmentBased on the most recent information from CMS, provider Annette Kazibwe Nazziwa does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 12:07 PM.Profile DetailsProvider ID1154670248Provider TypeIndividualFull NameNazziwa, Annette KazibweCredentialLICSWGenderFemaleSole ProprietorYesEnumeration Date9/5/2012Last Updated8/3/2018Contact InformationPractice LocationPractice Address30 Dimock St, Roxbury, MA 02119Phone(617) 989-2938Fax(617) 445-9147Mailing LocationMailing Address30 Dimock St, Roxbury, MA 02119-1210Phone(617) 989-2938Fax(617) 445-9147Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense120801MassachusettsCode1041C0700XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense218069Massachusetts