Provider Demographics
NPI:1972268407
Name:OGBONNA, STELLA EGUMA
Entity Type:Individual
Prefix:MRS
First Name:STELLA
Middle Name:EGUMA
Last Name:OGBONNA
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 1:7615 BLOSSOMMIST LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2788
Mailing Address - Country:US
Mailing Address - Phone:832-343-2755
Mailing Address - Fax:
Practice Address - Street 1:10701 CORPORATE DR STE 111
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-4018
Practice Address - Country:US
Practice Address - Phone:832-343-2755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-31
Last Update Date:2021-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83302101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health