Provider Demographics
NPI:1710231790
Name:ADEMOLA, FLORENCE BOSE (MSW)
Entity Type:Individual
Prefix:MS
First Name:FLORENCE
Middle Name:BOSE
Last Name:ADEMOLA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 FROYLE CT
Mailing Address - Street 2:
Mailing Address - City:ROLESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27571-9584
Mailing Address - Country:US
Mailing Address - Phone:919-961-6086
Mailing Address - Fax:
Practice Address - Street 1:400 FROYLE CT
Practice Address - Street 2:
Practice Address - City:ROLESVILLE
Practice Address - State:NC
Practice Address - Zip Code:27571
Practice Address - Country:US
Practice Address - Phone:919-961-6086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP007490104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker