Provider Demographics
NPI:1053976811
Name:ASKEW, OCTAVIA ANTOINETTE (PHD)
Entity type:Individual
Prefix:
First Name:OCTAVIA
Middle Name:ANTOINETTE
Last Name:ASKEW
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MRS
Other - First Name:OCTAVIA
Other - Middle Name:ANTOINETTE
Other - Last Name:ASKEW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OCTAVIA ASKEW, PHD
Mailing Address - Street 1:5412 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-4126
Mailing Address - Country:US
Mailing Address - Phone:424-789-0439
Mailing Address - Fax:323-325-7163
Practice Address - Street 1:5412 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037-4126
Practice Address - Country:US
Practice Address - Phone:424-789-0439
Practice Address - Fax:323-325-7163
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-07
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No251C00000XAgenciesDay Training, Developmentally Disabled Services