Individual
CLEMENT C OKONGWU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
867 GRAMERCY HILLS LN, MABLETON, GA 30126-7250
(551) 208-4703
Mailing address
867 GRAMERCY HILLS LN, MABLETON, GA 30126-7250
(551) 208-4703
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2022139428
GA
Other
Enumeration date
02/27/2023
Last updated
02/27/2023
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