Provider Demographics
NPI:1063960292
Name:AJUOGA, PAUL OGUNA (LIMHP)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:OGUNA
Last Name:AJUOGA
Suffix:
Gender:M
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 GALVIN RD N APT 5
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-4840
Mailing Address - Country:US
Mailing Address - Phone:402-628-0001
Mailing Address - Fax:
Practice Address - Street 1:202 GALVIN RD N APT 5
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-4840
Practice Address - Country:US
Practice Address - Phone:402-628-0001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor