Provider Demographics
NPI:1306181623
Name:NWOKEDI, CHINONYELUM
Entity Type:Individual
Prefix:
First Name:CHINONYELUM
Middle Name:
Last Name:NWOKEDI
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 1:8877 FRANKWAY DR APT 1126
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-1913
Mailing Address - Country:US
Mailing Address - Phone:412-360-9493
Mailing Address - Fax:
Practice Address - Street 1:310 WAYNE ST
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009
Practice Address - Country:US
Practice Address - Phone:724-774-2677
Practice Address - Fax:724-774-0821
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-28
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL011184235Z00000X
TX110935235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist