Provider Demographics
NPI:1447930201
Name:EBENEZER-ALAWODE, JOY ONYINYECHI
Entity type:Individual
Prefix:MRS
First Name:JOY
Middle Name:ONYINYECHI
Last Name:EBENEZER-ALAWODE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JOY
Other - Middle Name:ONYINYECHI
Other - Last Name:UGBOAJA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15116 LAUREL OAKS LN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5509
Mailing Address - Country:US
Mailing Address - Phone:650-680-5367
Mailing Address - Fax:
Practice Address - Street 1:15116 LAUREL OAKS LN
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5509
Practice Address - Country:US
Practice Address - Phone:650-680-5367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator