Provider Demographics
NPI:1659190478
Name:OKOJIE, AMEN
Entity type:Individual
Prefix:
First Name:AMEN
Middle Name:
Last Name:OKOJIE
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 1:7524 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-7594
Mailing Address - Country:US
Mailing Address - Phone:443-328-4946
Mailing Address - Fax:
Practice Address - Street 1:1645 LIBERTY RD
Practice Address - Street 2:
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6521
Practice Address - Country:US
Practice Address - Phone:443-328-4946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-08
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP15768101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional