Provider Demographics
NPI:1518242205
Name:UCHE, AUGUSTINE I
Entity Type:Individual
Prefix:MR
First Name:AUGUSTINE
Middle Name:I
Last Name:UCHE
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 1:9210 S WESTERN AVE STE A-21
Mailing Address - Street 2:OKLAHOMA CITY,
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-2734
Mailing Address - Country:US
Mailing Address - Phone:405-812-1273
Mailing Address - Fax:405-895-7544
Practice Address - Street 1:9210 S WESTERN AVE STE A-21
Practice Address - Street 2:OKLAHOMA CITY,
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2734
Practice Address - Country:US
Practice Address - Phone:405-812-1273
Practice Address - Fax:405-895-7544
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health