Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist | 22756 | OK |
NPI | 1588933428 |
---|---|
Provider Name | Mr. Adekunle O Adeleye |
First Address | Oklahoma City, OK 73139-2970 |
Second Address | Oklahoma City, OK 73139-2970 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2011 |
Last Update Date | 21/12/2011 |