Provider Demographics
NPI:1326323395
Name:JIMOH, GANIU OLANREWAJU (BHRS)
Entity Type:Individual
Prefix:MR
First Name:GANIU
Middle Name:OLANREWAJU
Last Name:JIMOH
Suffix:
Gender:M
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 N. CLASSEN
Mailing Address - Street 2:SUITE 159
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118
Mailing Address - Country:US
Mailing Address - Phone:405-607-6670
Mailing Address - Fax:405-607-6671
Practice Address - Street 1:4801 N. CLASSEN
Practice Address - Street 2:SUITE 159
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118
Practice Address - Country:US
Practice Address - Phone:405-607-6670
Practice Address - Fax:405-607-6671
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health