Grace Oghale Osiezagha
Home Health in Lithonia, GA. Individual provider (NPI-1).
NPI number1053894618
StatusActive
Last updated in NPPESSep 10, 2018
Details
- NPI
- 1053894618
- Entity type
- Individual (NPI-1)
- Name
- Grace Oghale Osiezagha
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 10, 2018
- Last updated
- Sep 10, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251E00000X | Home Health | – | GA | Yes |
| 106S00000X | Behavior Technician | – | GA | |
| 172V00000X | Community Health Worker | – | GA | |
| 174H00000X | Health Educator | – | GA | |
| 175T00000X | Peer Specialist | – | GA | |
| 251S00000X | Community/Behavioral Health | – | GA |
Other names
- Grace Oghale Gordon (Other Name)
Practice location
5549 Mccrossin CirLithonia, GA 30038-4801
Phone 404-917-5112 · Fax 770-323-7512
Mailing address
5549 Mccrossin CirLithonia, GA 30038-4801
Phone 404-917-5112 · Fax 770-323-7512
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