Healthcare Provider Details

I. General information

NPI: 1003749243
Provider Name (Legal Business Name): VICTORIA OGBIMI-AIYEMOMI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 OHIO UNIVERSITY DEPT OF PSYCHOLOGY PORTER HALL ROOM 002
ATHENS OH
45701-2942
US

IV. Provider business mailing address

1 OHIO UNIVERSITY DEPT OF PSYCHOLOGY PORTER HALL ROOM 002
ATHENS OH
45701-2942
US

V. Phone/Fax

Practice location:
  • Phone: 740-593-0902
  • Fax: 740-593-4790
Mailing address:
  • Phone: 740-593-0902
  • Fax: 740-593-4790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: