Provider Demographics
NPI:1164763132
Name:ONI, ADESOLA F (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:ADESOLA
Middle Name:F
Last Name:ONI
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9517 CHICAGO AVE S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55420-4522
Mailing Address - Country:US
Mailing Address - Phone:612-554-7499
Mailing Address - Fax:
Practice Address - Street 1:9517 CHICAGO AVE S
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55420-4522
Practice Address - Country:US
Practice Address - Phone:612-554-7499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN186151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical