Provider Demographics
NPI:1265016372
Name:OJURI, ADETOKUNBOH (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ADETOKUNBOH
Middle Name:
Last Name:OJURI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 N HOUSTON LEVEE RD
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-6614
Mailing Address - Country:US
Mailing Address - Phone:901-290-3857
Mailing Address - Fax:901-235-9544
Practice Address - Street 1:800 N HOUSTON LEVEE RD
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-6614
Practice Address - Country:US
Practice Address - Phone:901-290-3857
Practice Address - Fax:901-235-9544
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-06
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist