Provider Demographics
NPI:1003310194
Name:ORIMMA, AMARACHI NWAOBIARA
Entity Type:Individual
Prefix:
First Name:AMARACHI
Middle Name:NWAOBIARA
Last Name:ORIMMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3204 SINGLETARY DR APT 239
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:LA
Mailing Address - Zip Code:70714-2358
Mailing Address - Country:US
Mailing Address - Phone:225-361-9465
Mailing Address - Fax:
Practice Address - Street 1:4242 HIGHWAY 19 STE B-3
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-3982
Practice Address - Country:US
Practice Address - Phone:225-757-5699
Practice Address - Fax:225-757-5845
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2018-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator