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NPI 1689995763

NPI 1689995763 : MICHAEL OLUWASANMI OLADIPO MHR, LPC : NORMAN, OK

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General NPI Number Information
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    NPI Number           |    1689995763
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    Entity Type          |    Individual 
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    Provider Name        |    MICHAEL OLUWASANMI OLADIPO MHR, LPC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/12/2010
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    Last Update Date     |    06/12/2010
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Provider Practice Location Address
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    Address Line         |    2212 VALLEY HOLW 
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    City                 |    NORMAN
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    State                |    OK
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    Zip                  |    73071-3678
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    Country              |    US
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    Telephone            |    405-310-3434
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    Fax                  |    405-310-3434
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Provider Business Mailing Address
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    Address Line         |    2212 VALLEY HOLW 
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    City                 |    NORMAN
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    State                |    OK
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    Zip                  |    73071-3678
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    Country              |    US
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    Telephone            |    405-310-3434
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    Fax                  |    405-310-3434
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    LPC NO. 4373
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    License Number State |    OK
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