Healthcare Provider Details

I. General information

NPI: 1831607753
Provider Name (Legal Business Name): JULIANA OKAH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2018
Last Update Date: 01/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

733 SLIGO AVE APT 314
SILVER SPRING MD
20910-4738
US

IV. Provider business mailing address

733 SLIGO AVE APT 314
SILVER SPRING MD
20910-4738
US

V. Phone/Fax

Practice location:
  • Phone: 651-497-9358
  • Fax:
Mailing address:
  • Phone: 651-497-9358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA11732
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: