Provider Demographics
NPI:1932947306
Name:OKHUNGU, FAITH ATIENO
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:ATIENO
Last Name:OKHUNGU
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 1:44 KRIS ALAN DR
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520-1001
Mailing Address - Country:US
Mailing Address - Phone:704-572-9841
Mailing Address - Fax:
Practice Address - Street 1:44 KRIS ALAN DR
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:MA
Practice Address - Zip Code:01520-1001
Practice Address - Country:US
Practice Address - Phone:704-572-9841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2340336163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health