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Individual

CHINONSO CHIDERA IBE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
308 HORTON ST STE B, GRAYSON, KY 41143-1599
(270) 283-3845
Mailing address
140 3RD ST APT 105, PIKEVILLE, KY 41501-1350

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
05/09/2022
Last updated
06/13/2022
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