Healthcare Provider Details

I. General information

NPI: 1760305635
Provider Name (Legal Business Name): OPHELIA OFILI
Entity Type: Individual
Gender:
Sole Proprietor: Y

Provider Other Name: OPHELIA KOSISOCHUKWU OFILI

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8226 RIVER PARK RD
BOWIE MD
20715-3367
US

IV. Provider business mailing address

8226 RIVER PARK RD
BOWIE MD
20715-3367
US

V. Phone/Fax

Practice location:
  • Phone: 240-354-3394
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: