Provider Demographics
NPI:1598059966
Name:OKORONKWO, CHINWENDU OGECHI KAYE
Entity Type:Individual
Prefix:MS
First Name:CHINWENDU
Middle Name:OGECHI KAYE
Last Name:OKORONKWO
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 1:1811 SE CLARK ST
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-6828
Mailing Address - Country:US
Mailing Address - Phone:479-366-8732
Mailing Address - Fax:
Practice Address - Street 1:4171 N CROSSOVER RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4591
Practice Address - Country:US
Practice Address - Phone:479-575-9471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor