Provider Demographics
NPI:1114348851
Name:OWOLOJA, DARE
Entity Type:Individual
Prefix:
First Name:DARE
Middle Name:
Last Name:OWOLOJA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4239 PENN AVE
Mailing Address - Street 2:SUITE 11
Mailing Address - City:SINKING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:19608-1373
Mailing Address - Country:US
Mailing Address - Phone:610-670-8800
Mailing Address - Fax:610-670-9800
Practice Address - Street 1:4239 PENN AVE
Practice Address - Street 2:SUITE 11
Practice Address - City:SINKING SPRING
Practice Address - State:PA
Practice Address - Zip Code:19608-1373
Practice Address - Country:US
Practice Address - Phone:610-670-8800
Practice Address - Fax:610-670-9800
Is Sole Proprietor?:No
Enumeration Date:2013-12-24
Last Update Date:2013-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor