Provider Demographics
NPI:1154194660
Name:OGBONNA, JULIET O
Entity type:Individual
Prefix:
First Name:JULIET
Middle Name:O
Last Name:OGBONNA
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 1:3407 LA SEINE LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-4135
Mailing Address - Country:US
Mailing Address - Phone:281-790-9906
Mailing Address - Fax:
Practice Address - Street 1:1544 SAWDUST RD STE 260
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-2986
Practice Address - Country:US
Practice Address - Phone:832-303-8933
Practice Address - Fax:832-383-3817
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111655104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker