Healthcare Provider Details

I. General information

NPI: 1619670106
Provider Name (Legal Business Name): SONIA OBEHI OKOJIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2023
Last Update Date: 03/23/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S GREENE ST
BALTIMORE MD
21201-1544
US

IV. Provider business mailing address

5 HARD SPRING CT # MD21117
OWINGS MILLS MD
21117-4992
US

V. Phone/Fax

Practice location:
  • Phone: 443-583-9801
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR232939
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: