Healthcare Provider Details

I. General information

NPI: 1336426402
Provider Name (Legal Business Name): UCHENNA OBIOMA OKORIE BHRS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2011
Last Update Date: 11/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 GREENBRIAR PL
OKLAHOMA CITY OK
73159-7640
US

IV. Provider business mailing address

12500 ABBOTTS WAY
OKLAHOMA CITY OK
73142-4509
US

V. Phone/Fax

Practice location:
  • Phone: 405-376-3683
  • Fax: 405-735-3524
Mailing address:
  • Phone: 405-470-0556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: