Provider Demographics
NPI:1346967981
Name:OLATUNDE, ALEISHA
Entity Type:Individual
Prefix:MRS
First Name:ALEISHA
Middle Name:
Last Name:OLATUNDE
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 1:4810 NE VIVION RD
Mailing Address - Street 2:PO BOX 25502
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119
Mailing Address - Country:US
Mailing Address - Phone:314-402-4544
Mailing Address - Fax:
Practice Address - Street 1:6135 N ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-3077
Practice Address - Country:US
Practice Address - Phone:314-402-4544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty