MEDICARE: MS. CHIGOZIE EDNAH OBICHUKU LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	86943	TX

General Provider Information

NPI Number	:	1043063019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHIGOZIE EDNAH OBICHUKU LPC

Provider Business Mailing Address
First Line	:	12325 SHADOW CREEK PKWY APT 113
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-7373
Country	:	US
Telephone Number	:	830-339-2498
Fax Number	:

Provider Business Practice Location Address
First Line	:	11100 SOUTHWEST FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77031-3602
Country	:	US
Telephone Number	:	346-219-0434
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2024
Last Update Date	:	04/09/2024

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