Provider Demographics
NPI:1932321817
Name:ENEKWECHI, EMMANUEL E (PSYD)
Entity Type:Individual
Prefix:DR
First Name:EMMANUEL
Middle Name:E
Last Name:ENEKWECHI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 S DUBUQUE ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-4249
Mailing Address - Country:US
Mailing Address - Phone:319-354-8057
Mailing Address - Fax:319-354-3623
Practice Address - Street 1:720 S DUBUQUE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-4249
Practice Address - Country:US
Practice Address - Phone:319-354-8057
Practice Address - Fax:319-354-3623
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA767103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist