Provider Demographics
NPI:1699278291
Name:ONWUKA, CHUKWUDI LUKE
Entity type:Individual
Prefix:
First Name:CHUKWUDI
Middle Name:LUKE
Last Name:ONWUKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3127 LORENZO LN
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:MD
Mailing Address - Zip Code:21797-7501
Mailing Address - Country:US
Mailing Address - Phone:410-424-9668
Mailing Address - Fax:
Practice Address - Street 1:1651 OLD MEADOW ROAD SUITE 600
Practice Address - Street 2:
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22102
Practice Address - Country:US
Practice Address - Phone:703-564-1662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-10
Last Update Date:2018-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician