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Individual
JOANA ABENA FAGBOLA
Active
Individual
JOANA ABENA FAGBOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
092894-1
NY
1041C0700X
Clinical Social Worker
Primary
012692
CT
1041C0700X
Clinical Social Worker
093759-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1952-476-988
MONTEFIORE MEDICAL CENTER
NY
Enumeration date
06/19/2018
Last updated
02/07/2023
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