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Individual
OSATO EGONMWAN IDUBOR
Active
Individual
OSATO EGONMWAN IDUBOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0904015894
VA
1041C0700X
Clinical Social Worker
Primary
LC200002541
DC
1041C0700X
Clinical Social Worker
LICSW124558
MA
Other
Enumeration date
02/16/2020
Last updated
03/03/2025
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