Provider Demographics
NPI:1487467049
Name:ENYINNAH, SANDRA UGOCHI
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:UGOCHI
Last Name:ENYINNAH
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 1:47624 LINDENHURST BLVD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-3291
Mailing Address - Country:US
Mailing Address - Phone:248-818-3769
Mailing Address - Fax:
Practice Address - Street 1:47624 LINDENHURST BLVD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-3291
Practice Address - Country:US
Practice Address - Phone:248-818-3769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty