Provider Demographics
NPI:1750199345
Name:ADEYEMO, OMOLOLA
Entity type:Individual
Prefix:
First Name:OMOLOLA
Middle Name:
Last Name:ADEYEMO
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 1:6839 ARROWHEAD DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-7062
Mailing Address - Country:US
Mailing Address - Phone:317-767-5222
Mailing Address - Fax:
Practice Address - Street 1:6839 ARROWHEAD DR
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-7062
Practice Address - Country:US
Practice Address - Phone:317-767-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach