Provider Demographics
NPI:1891017026
Name:IKPA, JOSEPHINE A
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:A
Last Name:IKPA
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 1:3013 SUMMIT CROSSING PKWY
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-0617
Mailing Address - Country:US
Mailing Address - Phone:405-202-6148
Mailing Address - Fax:
Practice Address - Street 1:3013 SUMMIT CROSSING PKWY
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-0617
Practice Address - Country:US
Practice Address - Phone:405-202-6148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-15
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health