Most Relevant Information
Provider Data
| NPI Number: | 1003568627 |
| Provider Name: | IKENNA IGWE |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/25/2022 |
| Last Updated: | 01/25/2022 |
Provider Practice Location
9600 CENTER AVE
RANCHO CUCAMONGA
CA
917305838
Practice Location Phone/Fax
| Phone: | 8582645858 |
| Fax: |
Provider Mailing Location
PO BOX 8544
PASADENA
CA
911098602
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |