Provider Demographics
NPI:1558962225
Name:ODIGWE, CHINYERE RENEE (MSOT OTR/L)
Entity Type:Individual
Prefix:
First Name:CHINYERE
Middle Name:RENEE
Last Name:ODIGWE
Suffix:
Gender:F
Credentials:MSOT OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7413 ABBINGTON DR
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-1508
Mailing Address - Country:US
Mailing Address - Phone:301-832-1949
Mailing Address - Fax:
Practice Address - Street 1:7413 ABBINGTON DR
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-1508
Practice Address - Country:US
Practice Address - Phone:301-832-1949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-08
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08696225X00000X
DCOT010001630225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty