Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 010000929 | DC |
N | 225X00000X | Occupational Therapist | 016890 | NY |
N | 225X00000X | Occupational Therapist | 113566 | TX |
N | 225X00000X | Occupational Therapist | 12397 | CA |
NPI | 1003256199 |
---|---|
Provider Name | Ikechukwu Anthony Igbo II |
First Address | Houston, TX 77083-5240 |
Second Address | Houston, TX 77083-5240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2013 |
Last Update Date | 30/11/2020 |