| Doctor Name: | GOZIAM OGWU |
| NPI Number: | 1760889588 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | LGP5676 |
| Business Practice Address: | 6707 Whitestone Rd Suite 106 Woodlawn, MD - 212074106 |
| Business Phone Number: | 4102658737 |
| Business Fax Number: | 4102651258 |
| Mailing Address: | 2907 Fallstaff Rd, 24 BALTIMORE |
| State: | MD |
| Postal Code: | 212093264 |
| Phone Number: | 7575257733 |
| Fax Number: | |
| NPI Enumeration Date: | 11/21/2014 |
| NPI Last Update Date: | 11/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LGP5676 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |