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General NPI Number Information
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NPI Number | 1114806973
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Entity Type | Individual
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Provider Name | ADIJAT ADETOUN LAWAL
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Gender | Female
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Dates
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Enumeration Date | 08/27/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 9045 E 59TH ST BLDG 420
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City | INDIANAPOLIS
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State | IN
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Zip | 46216-1030
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Country | US
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Telephone | 317-554-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 1521 WEDGEWOOD PL
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City | AVON
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State | IN
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Zip | 46123-5575
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Country | US
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Telephone | 317-748-5759
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 28264355A
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License Number State | IN
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