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Individual
MOYOSORE MOSES FABIYI
Active
Individual
MOYOSORE MOSES FABIYI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YM0800X
Mental Health Counselor
Primary
178.015275
IL
101YM0800X
Mental Health Counselor
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376001106006
—
IL
05
—
376001106007
—
IL
Enumeration date
08/29/2017
Last updated
11/02/2022
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