Provider Demographics
NPI:1497476923
Name:OKORIE-UKAEGBU, CHINENYE PEACE
Entity Type:Individual
Prefix:
First Name:CHINENYE
Middle Name:PEACE
Last Name:OKORIE-UKAEGBU
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 1:723 UNDERWOOD ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-2663
Mailing Address - Country:US
Mailing Address - Phone:301-549-8235
Mailing Address - Fax:
Practice Address - Street 1:816 THAYER AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4508
Practice Address - Country:US
Practice Address - Phone:301-755-6107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician