Provider Demographics
NPI:1083271506
Name:UMOH, ENO-OBONG (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ENO-OBONG
Middle Name:
Last Name:UMOH
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6939 GEORGIA AVE NW APT 611
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-2446
Mailing Address - Country:US
Mailing Address - Phone:202-384-9593
Mailing Address - Fax:
Practice Address - Street 1:4200 HAREWOOD RD NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-1511
Practice Address - Country:US
Practice Address - Phone:202-269-1831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCSLP000454235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist