MEDICARE: JUDITH OSUAGWU

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YS0200X	School Counselor
3	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1912508698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH OSUAGWU

Provider Business Mailing Address
First Line	:	PO BOX 637
Second Line	:
City	:	AVONDALE
State	:	AZ
Zip	:	85323-0222
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3550 E PINCHOT AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-7434
Country	:	US
Telephone Number	:	623-806-2965
Fax Number	:

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

Provider Enumeration Date	:	11/08/2020
Last Update Date	:	02/23/2021

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Directions to “ JUDITH OSUAGWU ” Practice Location

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