Doctor Name: | MR. AUSTIN OBIKA |
NPI Number: | 1033169834 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 5095 |
Business Practice Address: | 215 Commerce St Swcmhc/clarendon County Mental Health Clinic Manning, SC - 291022638 |
Business Phone Number: | 8034952124 |
Business Fax Number: | 8034358113 |
Mailing Address: | Swcmhc, 215 N. Magnolia St., SUMTER |
State: | SC |
Postal Code: | 291511946 |
Phone Number: | 8037759364 |
Fax Number: | 8037736615 |
NPI Enumeration Date: | 05/11/2006 |
NPI Last Update Date: | 12/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 5095 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |