Individual
IFEOMA UMELO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1921 WATERS DR, RALEIGH, NC 27610-4836
(919) 539-9223
Mailing address
2204 HAVERING PL, RALEIGH, NC 27604-0801
(919) 539-9223
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
MHL-092-973
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
C201919301765
—
NC
Enumeration date
12/10/2019
Last updated
12/10/2019
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