Provider Demographics
NPI:1891236659
Name:NDIMKAOHA, JOSIE ONI (OT)
Entity Type:Individual
Prefix:MRS
First Name:JOSIE
Middle Name:ONI
Last Name:NDIMKAOHA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 HOWARDS TRUST CT
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-8351
Mailing Address - Country:US
Mailing Address - Phone:301-502-4393
Mailing Address - Fax:
Practice Address - Street 1:313 HOWARDS TRUST CT
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060-8351
Practice Address - Country:US
Practice Address - Phone:301-502-4393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04703225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist