Individual
IJOMA C OKWUOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2275 SILAS DEANE HWY, ROCKY HILL, CT 06067
(860) 996-1569
Mailing address
363 MAIN ST, MIDDLETOWN, CT 06457-3359
(678) 665-4132
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
001195
CT
101YP2500X
Professional Counselor
Primary
003432
CT
Other
Enumeration date
11/08/2017
Last updated
11/28/2018
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