Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 009681 | GA |
N | 101YM0800X | Mental Health Counselor | 009681 | GA |
N | 101YP1600X | Pastoral Counselor | 009681 | GA |
Y | 101YP2500X | Professional Counselor | 009681 | GA |
NPI | 1346864303 |
---|---|
Provider Name | Oluwafunmilayo K Adebayo |
First Address | Lawrenceville, GA 30046-8863 |
Second Address | Lawrenceville, GA 30043-3616 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2020 |
Last Update Date | 04/06/2020 |