Provider Demographics
NPI:1669154001
Name:OGBONNA, CHIDINMA
Entity type:Individual
Prefix:MISS
First Name:CHIDINMA
Middle Name:
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 1:1103 DANBURY DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-3235
Mailing Address - Country:US
Mailing Address - Phone:240-437-8606
Mailing Address - Fax:
Practice Address - Street 1:20400 OBSERVATION DR STE 104
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4086
Practice Address - Country:US
Practice Address - Phone:301-540-0445
Practice Address - Fax:833-803-2521
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02758235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist