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Organization

DUCKLAND HOMES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
REGINA OGHENETEGA OTTAN-OBI (CEO)
(248) 842-2852
Entity
Organization

Contact information

Practice address
1906 DRIVER GREEN LN, KATY, TX 77493-2340
(248) 842-2852
Mailing address
1906 DRIVER GREEN LN, KATY, TX 77493-2340
(248) 842-2852

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10812201100001
AETNA
TX
Enumeration date
10/31/2019
Last updated
10/31/2019
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