Provider Demographics
NPI:1346916723
Name:EKWUABU, NWAKAEGO
Entity Type:Individual
Prefix:
First Name:NWAKAEGO
Middle Name:
Last Name:EKWUABU
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 1:3301 WHEELER RD SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-4129
Mailing Address - Country:US
Mailing Address - Phone:802-338-8987
Mailing Address - Fax:
Practice Address - Street 1:3301 WHEELER RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4129
Practice Address - Country:US
Practice Address - Phone:802-338-8987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG500834411041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool