Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP144529 | TX |
NPI | 1003456542 |
---|---|
Provider Name | Catherine Ogbonna |
First Address | Rosenberg, TX 77469-4676 |
Second Address | Richmond, TX 77469-1419 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2020 |
Last Update Date | 13/01/2020 |