Individual
GLEN EHICHEOYA ORIAIFO
Active
Individual
GLEN EHICHEOYA ORIAIFO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
01083103A
IN
2084P0800X
Psychiatry Physician
Primary
01083103A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01083103A
LICENSE
IN
01
—
01083103B
CSR
IN
05
—
300042757
—
IN
Enumeration date
05/03/2016
Last updated
09/25/2024
Update your record
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