Provider Demographics
NPI:1134968597
Name:BABATUNDE, BUKOLA GBOTEMI
Entity type:Individual
Prefix:
First Name:BUKOLA
Middle Name:GBOTEMI
Last Name:BABATUNDE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 E HARVARD AVE APT 207
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5237
Mailing Address - Country:US
Mailing Address - Phone:720-736-9924
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL SCIENCES
Practice Address - Street 2:MSC09-5030
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-2237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-23
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health