Individual
SIMEON SOBENNA EKUGWUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2439 MANHATTAN BLVD STE 308, HARVEY, LA 70058-5396
(504) 366-5265
Mailing address
18 ROB LN, JACKSON, MS 39212-5927
(601) 842-0971
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PLC9826
LA
171M00000X
Case Manager/Care Coordinator
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
347E00000X
Transportation Broker
—
—
Other
Enumeration date
11/01/2019
Last updated
09/29/2023
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