MEDICARE: EMMAREX E OKHAKHU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1043096837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMAREX E OKHAKHU

Provider Business Mailing Address
First Line	:	602 N HIGH SCHOOL RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46214-3694
Country	:	US
Telephone Number	:	317-531-9288
Fax Number	:

Provider Business Practice Location Address
First Line	:	602 N HIGH SCHOOL RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46214-3694
Country	:	US
Telephone Number	:	317-531-9288
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2023
Last Update Date	:	09/06/2023

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Directions to “ EMMAREX E OKHAKHU ” Practice Location

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