Provider Demographics
NPI:1922688365
Name:OLASAKIN, EFE FELICITY
Entity Type:Individual
Prefix:
First Name:EFE
Middle Name:FELICITY
Last Name:OLASAKIN
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 1:489 BRIDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-7057
Mailing Address - Country:US
Mailing Address - Phone:317-444-0408
Mailing Address - Fax:
Practice Address - Street 1:489 BRIDGEWATER DR
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-7057
Practice Address - Country:US
Practice Address - Phone:317-444-0408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99102804A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health