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General NPI Number Information
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NPI Number | 1013626829
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Entity Type | Individual
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Provider Name | TAIWO SOWUNMI
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Gender | Male
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Dates
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Enumeration Date | 11/21/2022
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | OPTIONS BEHAVIORAL HEALTH SERVICES 5602 CAITO DRIVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46226-4622
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Country | US
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Telephone | 317-300-4807
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Fax |
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Provider Business Mailing Address
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Address Line | 10293 KINGS GAP WAY
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City | INDIANAPOLIS
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State | IN
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Zip | 46234-9832
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Country | US
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Telephone | 317-258-7119
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 7101328A
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License Number State | IN
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