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NPI Code Detail

MEDICARE: MRS. CHRISTINA OKPO UMANA MS NCC LPC AMFT

MEDICARE: MRS. CHRISTINA OKPO UMANA MS NCC LPC AMFT
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
1101YM0800XMental Health CounselorIL

General Provider Information

NPI Number : 1659428845
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTINA OKPO UMANA MS NCC LPC AMFT
Provider Business Mailing Address
First Line : 214 S UNIVERSITY AVE
Second Line :
City : CARBONDALE
State : IL
Zip : 62901-2925
Country : US
Telephone Number : 618-351-0743
Fax Number : 618-351-0945
Provider Business Practice Location Address
First Line : 214 S UNIVERSITY AVE
Second Line :
City : CARBONDALE
State : IL
Zip : 62901-2925
Country : US
Telephone Number : 618-351-0743
Fax Number : 618-351-0945
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2007
Last Update Date : 07/08/2007

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