Provider Demographics
NPI:1396444816
Name:ORAJEKWE, OLUCHI JOSEPHINE
Entity type:Individual
Prefix:
First Name:OLUCHI
Middle Name:JOSEPHINE
Last Name:ORAJEKWE
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 1:8220 HARVEST BEND LN APT 41
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-6145
Mailing Address - Country:US
Mailing Address - Phone:240-334-8596
Mailing Address - Fax:
Practice Address - Street 1:8220 HARVEST BEND LN APT 41
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-6145
Practice Address - Country:US
Practice Address - Phone:240-334-8596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-23
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC200002250101YP2500X
MDLGP13478101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD92-0456939Medicaid