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NPI Code Detail

MEDICARE: MONET OLORUNNISOMO

MEDICARE: MONET OLORUNNISOMO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1982016895
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONET OLORUNNISOMO
Provider Business Mailing Address
First Line : 9700 SOUTH PENNSYLVANIA AVE.
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73159
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9700 S PENNSYLVANIA AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73159-6917
Country : US
Telephone Number : 405-735-9732
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2014
Last Update Date : 05/13/2015

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Directions to “ MONET OLORUNNISOMO ” Practice Location

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