Provider Demographics
NPI:1457827461
Name:ADU BOFFOUR, EUNICE A OPOKU (LSW)
Entity Type:Individual
Prefix:MRS
First Name:EUNICE
Middle Name:A OPOKU
Last Name:ADU BOFFOUR
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:EUNICE
Other - Middle Name:AKOSUA
Other - Last Name:OPOKU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:525 METRO PL N
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-5342
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:525 METRO PL N
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-5342
Practice Address - Country:US
Practice Address - Phone:614-339-1632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2910854Medicaid