Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health |
NPI | 1659812097 |
---|---|
Provider Name | Godfrey Ugiagbe |
First Address | Columbus, OH 43229-4540 |
Second Address | Columbus, OH 43229-4540 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2017 |
Last Update Date | 18/03/2017 |