Healthcare Provider Details

I. General information

NPI: 1972971968
Provider Name (Legal Business Name): MICHELLE OKAFOR AUD.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2015
Last Update Date: 11/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5430 CAMPBELL BLVD SUITE 212
WHITE MARSH MD
21162-5500
US

IV. Provider business mailing address

7476 NEW RIDGE RD SUITE H
HANOVER MD
21076-3177
US

V. Phone/Fax

Practice location:
  • Phone: 443-725-5725
  • Fax: 443-725-5738
Mailing address:
  • Phone: 410-582-8981
  • Fax: 410-582-8992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number01365
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number01365
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: