Provider Demographics
NPI:1578985628
Name:AIKHORIN, OLUWASEUN DESMOND
Entity Type:Individual
Prefix:
First Name:OLUWASEUN
Middle Name:DESMOND
Last Name:AIKHORIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 NW 34TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-3203
Mailing Address - Country:US
Mailing Address - Phone:405-779-8805
Mailing Address - Fax:
Practice Address - Street 1:1501 NW 34TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-3203
Practice Address - Country:US
Practice Address - Phone:405-779-8805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst