Healthcare Provider Details

I. General information

NPI: 1588582332
Provider Name (Legal Business Name): NGOZI U ONYEANI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2476 E SOURWOOD CT
GILBERT AZ
85298-3412
US

IV. Provider business mailing address

2476 E SOURWOOD CT
GILBERT AZ
85298-3412
US

V. Phone/Fax

Practice location:
  • Phone: 404-902-0080
  • Fax:
Mailing address:
  • Phone: 404-902-0080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number24185
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: