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General NPI Number Information
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NPI Number | 1255041711
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Entity Type | Individual
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Provider Name | MR. SADIQ OLADAPO LAWAL
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Gender | Male
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Dates
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Enumeration Date | 11/24/2022
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Last Update Date | 11/24/2022
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Provider Practice Location Address
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Address Line | 606 FARMS DR
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City | BURLINGTON
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State | MA
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Zip | 01803-3746
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Country | US
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Telephone | 774-417-7473
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Fax |
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Provider Business Mailing Address
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Address Line | 62 FREDERICK ST APT 32
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City | DRACUT
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State | MA
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Zip | 01826-3450
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Country | US
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Telephone | 774-417-7473
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 20R8-0L3V-STLT
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License Number State | MA
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