Healthcare Provider Details

I. General information

NPI: 1891315131
Provider Name (Legal Business Name): NDIDIAMAKA OKPALA CNA ,HHA,BHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2020
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 K ST NE
WASHINGTON DC
20002-4216
US

IV. Provider business mailing address

3941 WARNER AVE APT A7
HYATTSVILLE MD
20784-2088
US

V. Phone/Fax

Practice location:
  • Phone: 202-371-9393
  • Fax: 202-697-5069
Mailing address:
  • Phone: 443-683-4372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA15351
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License NumberA00173797
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberNA0000813914
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: