Provider Demographics
NPI:1114758307
Name:ETOKHANA, REMI JENNIFER
Entity type:Individual
Prefix:
First Name:REMI
Middle Name:JENNIFER
Last Name:ETOKHANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 STALLION CT
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08094-8745
Mailing Address - Country:US
Mailing Address - Phone:609-916-9734
Mailing Address - Fax:856-481-6384
Practice Address - Street 1:1801 STALLION CT
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08094-8745
Practice Address - Country:US
Practice Address - Phone:609-916-9734
Practice Address - Fax:856-481-6384
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator