Provider Demographics
NPI:1144784539
Name:OKALA, ROSELINE OGHENESEME (MSW)
Entity Type:Individual
Prefix:
First Name:ROSELINE
Middle Name:OGHENESEME
Last Name:OKALA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MRS
Other - First Name:ROSELINE
Other - Middle Name:OGHENESEME
Other - Last Name:OKALA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:188 BEN BURTON CIR
Mailing Address - Street 2:
Mailing Address - City:BOGART
Mailing Address - State:GA
Mailing Address - Zip Code:30622-6802
Mailing Address - Country:US
Mailing Address - Phone:470-583-8755
Mailing Address - Fax:
Practice Address - Street 1:3772 EMPERORS CV
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-7126
Practice Address - Country:US
Practice Address - Phone:678-863-0063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker