Provider Demographics
NPI:1013200823
Name:NDUBUEZE, CHIDIEBERE GLORIA (LPC, LADC)
Entity Type:Individual
Prefix:
First Name:CHIDIEBERE
Middle Name:GLORIA
Last Name:NDUBUEZE
Suffix:
Gender:F
Credentials:LPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4917 N PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-6113
Mailing Address - Country:US
Mailing Address - Phone:405-412-6218
Mailing Address - Fax:
Practice Address - Street 1:4917 N PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-6113
Practice Address - Country:US
Practice Address - Phone:405-412-6218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor