Provider Demographics
NPI:1437841269
Name:ATIROKO, ADEDAMOLA FESTUS (SLP)
Entity Type:Individual
Prefix:
First Name:ADEDAMOLA
Middle Name:FESTUS
Last Name:ATIROKO
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-2973
Mailing Address - Country:US
Mailing Address - Phone:210-284-7944
Mailing Address - Fax:
Practice Address - Street 1:504 WILSON ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-2973
Practice Address - Country:US
Practice Address - Phone:210-284-7944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL61446298235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist