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Individual
MRS. DEBORAH BOLANLE FAMUYIDE
Active
Individual
MRS. DEBORAH BOLANLE FAMUYIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, CASAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
11507
NY
1041C0700X
Clinical Social Worker
Primary
R053768
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D1983848
—
NY
Enumeration date
11/13/2006
Last updated
01/26/2012
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