Individual
EMMANUEL OGHENEKARO ETUKE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
2750 KILLARNEY DR STE 100, WOODBRIDGE, VA 22192-4124
(202) 809-3928
Mailing address
2750 KILLARNEY DR STE 100, WOODBRIDGE, VA 22192-4124
(202) 809-3928
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC14862
MD
101YP2500X
Professional Counselor
LC14862
MD
Other
Enumeration date
01/14/2021
Last updated
04/17/2024
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