Provider Demographics
NPI:1346949807
Name:OKOTIE BROTHERS, OJOMA (RBT)
Entity Type:Individual
Prefix:MS
First Name:OJOMA
Middle Name:
Last Name:OKOTIE BROTHERS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 N NELLIS BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-5390
Mailing Address - Country:US
Mailing Address - Phone:702-525-7918
Mailing Address - Fax:
Practice Address - Street 1:320 N NELLIS BLVD STE 6
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-5390
Practice Address - Country:US
Practice Address - Phone:702-525-7918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty