Provider Demographics
NPI:1508564063
Name:ERIOBU, TOCHUKWU STANLEY
Entity Type:Individual
Prefix:
First Name:TOCHUKWU
Middle Name:STANLEY
Last Name:ERIOBU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 UNITED CT
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MD
Mailing Address - Zip Code:21001-1290
Mailing Address - Country:US
Mailing Address - Phone:443-558-8191
Mailing Address - Fax:
Practice Address - Street 1:820 UNITED CT
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-1290
Practice Address - Country:US
Practice Address - Phone:443-558-8191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician