Individual
ADEMOLA AKINLAYO FATADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTA
Contact information
Practice address
2910 W DESOTO ST, PENSACOLA, FL 32505-6161
(850) 324-1494
(850) 782-0058
Mailing address
PO BOX 56, WATER VALLEY, MS 38965-0056
(850) 324-1494
(850) 782-0058
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
19726
FL
Other
Enumeration date
02/06/2024
Last updated
02/06/2024
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