Individual
OLUBUNMI C OLADOSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-3431
Mailing address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-3431
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
821396-01
NY
163WP0808X
Psychiatric/Mental Health Registered Nurse
928750
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1033338
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
F403596-01
NY
Other
Enumeration date
02/08/2021
Last updated
10/29/2021
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