Provider Demographics
NPI:1720520927
Name:ALAGBE, AKEEM
Entity Type:Individual
Prefix:
First Name:AKEEM
Middle Name:
Last Name:ALAGBE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 TWIN FLOWER CIR
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-8024
Mailing Address - Country:US
Mailing Address - Phone:614-596-0162
Mailing Address - Fax:
Practice Address - Street 1:2006 TWIN FLOWER CIR
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-8024
Practice Address - Country:US
Practice Address - Phone:614-596-0162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-06
Last Update Date:2016-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH103TM1800X103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities