Provider Demographics
NPI:1275825630
Name:MUONELO, CHUDE (MS)
Entity Type:Individual
Prefix:MR
First Name:CHUDE
Middle Name:
Last Name:MUONELO
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 HOLLY HILL RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-5036
Mailing Address - Country:US
Mailing Address - Phone:405-501-5321
Mailing Address - Fax:405-606-7893
Practice Address - Street 1:816 HOLLY HILL RD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-5036
Practice Address - Country:US
Practice Address - Phone:405-501-5321
Practice Address - Fax:405-606-7893
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health