Provider Demographics
NPI:1285219881
Name:UKEEKWE, OLAEDO
Entity Type:Individual
Prefix:
First Name:OLAEDO
Middle Name:
Last Name:UKEEKWE
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 1:3416 PARK PL NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2528
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4200 S CAPITOL ST SE APT 204
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-1342
Practice Address - Country:US
Practice Address - Phone:202-428-5941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102X00000XBehavioral Health & Social Service ProvidersPoetry Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCNAOtherNA