Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 15688 | TX |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 15688 | TX |
N | 101YM0800X | Mental Health Counselor | 15688 | TX |
N | 101YP2500X | Professional Counselor | 15688 | TX |
N | 101YS0200X | School Counselor | 15688 | TX |
NPI | 1144232380 |
---|---|
Provider Name | Dr. Mary Chinelo Okafor |
First Address | Dallas, TX 75228-7135 |
Second Address | Dallas, TX 75228-7135 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 13/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
028635301 | (05) | TX |
155451 | VALUE OPTIONS PIN (01) | TX |
6123LC | BC/BS PIN (01) | TX |
7896512 | AETNA PIN (01) | TX |
H06123LC01 | BC/BS PIN (01) | TX |