Provider Demographics
NPI:1790123990
Name:NWIZU, CHINENYE
Entity Type:Individual
Prefix:
First Name:CHINENYE
Middle Name:
Last Name:NWIZU
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 1:4255 CHAMBLEE TUCKER RD
Mailing Address - Street 2:
Mailing Address - City:DORAVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30340-4501
Mailing Address - Country:US
Mailing Address - Phone:404-819-1271
Mailing Address - Fax:770-493-8000
Practice Address - Street 1:4255 CHAMBLEE TUCKER RD
Practice Address - Street 2:
Practice Address - City:DORAVILLE
Practice Address - State:GA
Practice Address - Zip Code:30340-4501
Practice Address - Country:US
Practice Address - Phone:404-819-1271
Practice Address - Fax:770-493-8000
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health