Provider Demographics
NPI:1861378184
Name:OGWUCHE, CHTAINI M
Entity type:Individual
Prefix:
First Name:CHTAINI
Middle Name:M
Last Name:OGWUCHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2945 BURDETTE ST
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-1054
Mailing Address - Country:US
Mailing Address - Phone:248-252-7037
Mailing Address - Fax:
Practice Address - Street 1:2945 BURDETTE ST
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-1054
Practice Address - Country:US
Practice Address - Phone:248-252-7037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health