Provider Demographics
NPI:1992108401
Name:AWELE, FLORENCE CHIKA
Entity type:Individual
Prefix:
First Name:FLORENCE
Middle Name:CHIKA
Last Name:AWELE
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 1:9301 BEECHNUT ST
Mailing Address - Street 2:APT 1914
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-6664
Mailing Address - Country:US
Mailing Address - Phone:713-505-2645
Mailing Address - Fax:
Practice Address - Street 1:9301 BEECHNUT ST
Practice Address - Street 2:APT 1914
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-6664
Practice Address - Country:US
Practice Address - Phone:713-505-2645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20969649103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities