Provider Demographics
NPI:1477910107
Name:OLOWOYO, OLUBUKOLA DANIELLE (MS, LAPC)
Entity Type:Individual
Prefix:MISS
First Name:OLUBUKOLA
Middle Name:DANIELLE
Last Name:OLOWOYO
Suffix:
Gender:F
Credentials:MS, LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3779 WESTCHASE VILLAGE LN
Mailing Address - Street 2:APT E
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-7230
Mailing Address - Country:US
Mailing Address - Phone:678-644-0232
Mailing Address - Fax:
Practice Address - Street 1:4536 BARCLAY DR
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-7145
Practice Address - Country:US
Practice Address - Phone:770-458-8711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC004902101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional