Provider Demographics
NPI:1588929939
Name:OKOLIE, THERESA CHINWE
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:CHINWE
Last Name:OKOLIE
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 1:3698 HAYES STREET, NE
Mailing Address - Street 2:# 202
Mailing Address - City:WASHINGTO
Mailing Address - State:DC
Mailing Address - Zip Code:20019
Mailing Address - Country:US
Mailing Address - Phone:202-547-2949
Mailing Address - Fax:
Practice Address - Street 1:3698 HAYES STREET, NE
Practice Address - Street 2:# 202
Practice Address - City:WASHINGTO
Practice Address - State:DC
Practice Address - Zip Code:20019
Practice Address - Country:US
Practice Address - Phone:202-547-2949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide