Provider Demographics
NPI:1093267684
Name:NWABUGWU, OBIOHA CHUKWUMA
Entity Type:Individual
Prefix:MR
First Name:OBIOHA
Middle Name:CHUKWUMA
Last Name:NWABUGWU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 E 72ND ST
Mailing Address - Street 2:APT 1306
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-5348
Mailing Address - Country:US
Mailing Address - Phone:214-254-0240
Mailing Address - Fax:
Practice Address - Street 1:1710 E 72ND ST
Practice Address - Street 2:APT 1306
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-5348
Practice Address - Country:US
Practice Address - Phone:214-254-0240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-29
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health