Provider Demographics
NPI:1043917594
Name:CLEMENT, JOAN CHIKAODI
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:CHIKAODI
Last Name:CLEMENT
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JOAN
Other - Middle Name:CHIKAODI
Other - Last Name:CLEMENT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AKALEFU
Mailing Address - Street 1:12911 SUTTERS LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4640
Mailing Address - Country:US
Mailing Address - Phone:240-486-1870
Mailing Address - Fax:
Practice Address - Street 1:12911 SUTTERS LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4640
Practice Address - Country:US
Practice Address - Phone:240-486-1870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health