Provider Demographics
NPI:1992528996
Name:OBILA, OGECHI JENNIFER
Entity type:Individual
Prefix:
First Name:OGECHI
Middle Name:JENNIFER
Last Name:OBILA
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 1:653 AMHERST RD
Mailing Address - Street 2:
Mailing Address - City:SUNDERLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01375-0501
Mailing Address - Country:US
Mailing Address - Phone:857-247-0877
Mailing Address - Fax:
Practice Address - Street 1:653 AMHERST RD
Practice Address - Street 2:
Practice Address - City:SUNDERLAND
Practice Address - State:MA
Practice Address - Zip Code:01375-0501
Practice Address - Country:US
Practice Address - Phone:857-247-0877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician