MEDICARE: EMMANUELLA CHIDINMA OJINNAKA

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	251S00000X	Community/Behavioral Health Agency	RBT-24-319644	TX
2	251S00000X	Community/Behavioral Health Agency	BCCS24270984	TX

General Provider Information

NPI Number	:	1548006893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMANUELLA CHIDINMA OJINNAKA

Provider Business Mailing Address
First Line	:	4718 CYPRESSBLUFF LN
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-4091
Country	:	US
Telephone Number	:	773-396-8387
Fax Number	:

Provider Business Practice Location Address
First Line	:	4718 CYPRESSBLUFF LN
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-4091
Country	:	US
Telephone Number	:	773-396-8387
Fax Number	:

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

Provider Enumeration Date	:	07/06/2024
Last Update Date	:	07/06/2024

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