Healthcare Provider Details

I. General information

NPI: 1760021984
Provider Name (Legal Business Name): DAMILOLA MOSEBOLATAN AKINTOLA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2020
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 NW 72ND ST STE 152
WARR ACRES OK
73132-5931
US

IV. Provider business mailing address

5601 NW 72ND ST STE 152
WARR ACRES OK
73132-5931
US

V. Phone/Fax

Practice location:
  • Phone: 405-839-7600
  • Fax:
Mailing address:
  • Phone: 405-839-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: