Provider Demographics
NPI:1578007845
Name:ONOBUN, AKHABUE
Entity Type:Individual
Prefix:
First Name:AKHABUE
Middle Name:
Last Name:ONOBUN
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 1:3300 HIGHLANDS PKWY SE
Mailing Address - Street 2:STE 110
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-5131
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3300 HIGHLANDS PKWY SE
Practice Address - Street 2:STE 110
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-5131
Practice Address - Country:US
Practice Address - Phone:470-265-4244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy