MEDICARE: ADEOLA YUSUF

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TM1800X	Intellectual & Developmental Disabilities Psychologist

General Provider Information

NPI Number	:	1174223168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADEOLA YUSUF

Provider Business Mailing Address
First Line	:	4424 RUDFORD DR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615-5419
Country	:	US
Telephone Number	:	419-279-6612
Fax Number	:

Provider Business Practice Location Address
First Line	:	3128 TREMAINSVILLE RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43613-1804
Country	:	US
Telephone Number	:	419-279-6612
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2023
Last Update Date	:	03/08/2023

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Directions to “ ADEOLA YUSUF ” Practice Location

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