Provider Demographics
NPI:1215750609
Name:ODAJI, EKOR WONAH (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:EKOR
Middle Name:WONAH
Last Name:ODAJI
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 RED MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-5294
Mailing Address - Country:US
Mailing Address - Phone:908-370-2902
Mailing Address - Fax:
Practice Address - Street 1:12 PENNINGTON ST STE 100
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-1026
Practice Address - Country:US
Practice Address - Phone:302-724-1181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEAN-0025824363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health