Individual
INIOBONG UDOFIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 DUDLEY ST, ROXBURY, MA 02119-2769
(617) 989-9499
Mailing address
520 DUDLEY ST, ROXBURY, MA 02119-2769
(617) 989-9499
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
05/15/2020
Last updated
05/15/2020
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