Provider Demographics
NPI:1689478091
Name:SOWUNMI, OLUWATOYIN SUSAN
Entity type:Individual
Prefix:
First Name:OLUWATOYIN
Middle Name:SUSAN
Last Name:SOWUNMI
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 1:309 ALDAY LN
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1274
Mailing Address - Country:US
Mailing Address - Phone:706-908-7447
Mailing Address - Fax:
Practice Address - Street 1:309 ALDAY LN
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1274
Practice Address - Country:US
Practice Address - Phone:706-908-7447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN288427163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health