Provider Demographics
NPI:1043594427
Name:OKOH, CHITUA ADA (PHD, RD, LDN, MPH)
Entity Type:Individual
Prefix:DR
First Name:CHITUA
Middle Name:ADA
Last Name:OKOH
Suffix:
Gender:F
Credentials:PHD, RD, LDN, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12219 CASTLEWALL CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3493
Mailing Address - Country:US
Mailing Address - Phone:301-352-7679
Mailing Address - Fax:
Practice Address - Street 1:12219 CASTLEWALL CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-3493
Practice Address - Country:US
Practice Address - Phone:301-352-7679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDN00035133N00000X, 133V00000X
DCD1710133N00000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist