Provider Demographics
NPI:1659812097
Name:UGIAGBE, GODFREY
Entity Type:Individual
Prefix:
First Name:GODFREY
Middle Name:
Last Name:UGIAGBE
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 1:5288 TAMARACK CIR E
Mailing Address - Street 2:B
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-4540
Mailing Address - Country:US
Mailing Address - Phone:614-373-8681
Mailing Address - Fax:
Practice Address - Street 1:5288 TAMARACK CIR E
Practice Address - Street 2:B
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-4540
Practice Address - Country:US
Practice Address - Phone:614-373-8681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-18
Last Update Date:2017-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health