Provider Demographics
NPI:1083124770
Name:ADENIKINJU, DEBORAH (BA)
Entity Type:Individual
Prefix:MISS
First Name:DEBORAH
Middle Name:
Last Name:ADENIKINJU
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 PUTNAM AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-1705
Mailing Address - Country:US
Mailing Address - Phone:917-912-3415
Mailing Address - Fax:
Practice Address - Street 1:297 PUTNAM AVE APT 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-1705
Practice Address - Country:US
Practice Address - Phone:917-912-3415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician