Individual
MISS OBIOMA QUEENETH MADUBUIKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYCH NP
Contact information
Practice address
1801 N HAMPTON RD STE 421, DESOTO, TX 75115-2391
(214) 208-1358
Mailing address
1801 N HAMPTON RD STE 421, DESOTO, TX 75115-2391
(214) 208-1358
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
924523
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1179274
TX
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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