Healthcare Provider Details

I. General information

NPI: 1811820475
Provider Name (Legal Business Name): UCHENNA ODIARI
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 10/11/2026
Certification Date: 10/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 S DETROIT AVE
TOLEDO OH
43614-2701
US

IV. Provider business mailing address

1135 S MAIN ST STE 215 #1070
BOWLING GREEN OH
43402-4750
US

V. Phone/Fax

Practice location:
  • Phone: 419-381-1881
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0042409
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: