Provider Demographics
NPI:1205394905
Name:ADEWOLE, HALIMATU
Entity Type:Individual
Prefix:MISS
First Name:HALIMATU
Middle Name:
Last Name:ADEWOLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 MURFREESBORO PIKE STE 702
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-2679
Mailing Address - Country:US
Mailing Address - Phone:844-359-7629
Mailing Address - Fax:615-577-5654
Practice Address - Street 1:5488 CHAMBLEE DUNWOODY RD STE 7
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-4161
Practice Address - Country:US
Practice Address - Phone:044-803-8424
Practice Address - Fax:615-577-5654
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician