Provider Demographics
NPI:1477316222
Name:OIRERE, WINNIE
Entity Type:Individual
Prefix:
First Name:WINNIE
Middle Name:
Last Name:OIRERE
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 1:24 CHESWOLD BLVD APT 2D
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-4175
Mailing Address - Country:US
Mailing Address - Phone:910-527-0093
Mailing Address - Fax:
Practice Address - Street 1:213 W 4TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-2204
Practice Address - Country:US
Practice Address - Phone:910-527-0093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEMT-0015193225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist