Individual
PRINCE ENE-OJO ETUH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3652 NEWBERRY RD, PLAINFIELD, IN 46168-7366
(317) 220-2209
Mailing address
3652 NEWBERRY RD, PLAINFIELD, IN 46168-7366
(317) 220-2209
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MATS-5308
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
93-4874217
CERTIFICATE OF AN ORGANIZATION
IN
Enumeration date
05/11/2026
Last updated
05/11/2026
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