Individual
BOLANLE FANILOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
681 HIOAKS RD STE J, RICHMOND, VA 23225-4043
(804) 533-1330
Mailing address
10100 PALACE WAY APT B, HENRICO, VA 23238-5646
(443) 416-9572
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0903002957
VA
104100000X
Social Worker
22958
MD
Other
Enumeration date
03/11/2020
Last updated
03/11/2020
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