Provider Demographics
NPI:1669729976
Name:OKAFOR, OBIAGELI N (MS)
Entity type:Individual
Prefix:
First Name:OBIAGELI
Middle Name:N
Last Name:OKAFOR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:496 W ANN ARBOR TRL
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-6262
Mailing Address - Country:US
Mailing Address - Phone:248-274-6016
Mailing Address - Fax:
Practice Address - Street 1:496 W ANN ARBOR TRL
Practice Address - Street 2:SUITE 202
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-6262
Practice Address - Country:US
Practice Address - Phone:248-274-6016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015782101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health