Provider Demographics
NPI:1275195695
Name:OLUOHA-ANYANWU, VERA CHIDIMA
Entity Type:Individual
Prefix:
First Name:VERA
Middle Name:CHIDIMA
Last Name:OLUOHA-ANYANWU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 N EASTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-2212
Mailing Address - Country:US
Mailing Address - Phone:334-277-0122
Mailing Address - Fax:
Practice Address - Street 1:458 N EASTERN BLVD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-2212
Practice Address - Country:US
Practice Address - Phone:334-277-0122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-05
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist