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General NPI Number Information
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NPI Number | 1649598103
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Entity Type | Individual
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Provider Name | INNOCENT ONYEMA NNONAH MSC
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Gender | Male
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Dates
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Enumeration Date | 05/08/2010
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Last Update Date | 05/08/2010
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Provider Practice Location Address
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Address Line | 2608 SW 59TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73119-6616
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Country | US
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Telephone | 405-604-0300
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Fax | 405-604-0301
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Provider Business Mailing Address
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Address Line | 6808 NW 25TH ST
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City | BETHANY
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State | OK
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Zip | 73008-5225
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Country | US
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Telephone | 405-789-3189
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Fax | 405-604-0301
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | NIL
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License Number State |
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