Provider Demographics
NPI:1356953244
Name:OLOYEDE, OLUWATOYIN ABOLORE
Entity type:Individual
Prefix:
First Name:OLUWATOYIN
Middle Name:ABOLORE
Last Name:OLOYEDE
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 1:10 OLD TYNG RD
Mailing Address - Street 2:
Mailing Address - City:TYNGSBORO
Mailing Address - State:MA
Mailing Address - Zip Code:01879-2706
Mailing Address - Country:US
Mailing Address - Phone:607-379-2898
Mailing Address - Fax:
Practice Address - Street 1:10 OLD TYNG RD
Practice Address - Street 2:
Practice Address - City:TYNGSBORO
Practice Address - State:MA
Practice Address - Zip Code:01879-2706
Practice Address - Country:US
Practice Address - Phone:607-379-2898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician