Provider Demographics
NPI:1215095195
Name:ELEJE, NGOZI KATHLEEN
Entity type:Individual
Prefix:
First Name:NGOZI
Middle Name:KATHLEEN
Last Name:ELEJE
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 1:4350 BOY SCOUT LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79922-2201
Mailing Address - Country:US
Mailing Address - Phone:915-633-3724
Mailing Address - Fax:915-533-0078
Practice Address - Street 1:4350 BOY SCOUT LN
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79922-2201
Practice Address - Country:US
Practice Address - Phone:915-633-3724
Practice Address - Fax:915-532-3143
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor