Healthcare Provider Details

I. General information

NPI: 1508283318
Provider Name (Legal Business Name): TONIA OKOYE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2014
Last Update Date: 03/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 QUEENS CHAPEL RD APT. 405
HYATTSVILLE MD
20782-3616
US

IV. Provider business mailing address

2400 QUEENS CHAPEL RD APT. 405
HYATTSVILLE MD
20782-3616
US

V. Phone/Fax

Practice location:
  • Phone: 678-964-0130
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA9876
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: