Provider Demographics
NPI:1437572906
Name:ONYEBUCHI, VIVIAN ADAEZE (OTR/L)
Entity type:Individual
Prefix:MISS
First Name:VIVIAN
Middle Name:ADAEZE
Last Name:ONYEBUCHI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:ADAEZE
Other - Middle Name:
Other - Last Name:ONYEBUCHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2717 COMMERCIAL CENTER BLVD.
Mailing Address - Street 2:SUITE E200 PMB #313
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-7823
Mailing Address - Country:US
Mailing Address - Phone:404-783-0954
Mailing Address - Fax:713-456-2781
Practice Address - Street 1:2717 COMMERCIAL CENTER BLVD STE E200
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-7823
Practice Address - Country:US
Practice Address - Phone:404-783-0954
Practice Address - Fax:713-456-2781
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112798251E00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No251E00000XAgenciesHome Health