Provider Demographics
NPI:1760021984
Name:AKINTOLA, DAMILOLA MOSEBOLATAN
Entity Type:Individual
Prefix:
First Name:DAMILOLA
Middle Name:MOSEBOLATAN
Last Name:AKINTOLA
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 1:5013 OAK MANOR DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73135-2235
Mailing Address - Country:US
Mailing Address - Phone:405-696-2323
Mailing Address - Fax:
Practice Address - Street 1:5013 OAK MANOR DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73135-2235
Practice Address - Country:US
Practice Address - Phone:405-696-2323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)