Provider Demographics
NPI:1053186973
Name:OKOMA, SYLVIA CHIDINMA-NNENA
Entity type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:CHIDINMA-NNENA
Last Name:OKOMA
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 1:4943 MOUNTAINSIDE TRL
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-3697
Mailing Address - Country:US
Mailing Address - Phone:678-333-4630
Mailing Address - Fax:
Practice Address - Street 1:120 W TRINITY PL
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-3313
Practice Address - Country:US
Practice Address - Phone:678-333-4630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-21
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No251K00000XAgenciesPublic Health or Welfare